摘要
目的探讨原发性肝癌门静脉癌栓合并肝门淋巴结转移的手术疗效。方法 2001年1月～2003年12月28例肝癌伴门静脉癌栓术中发现肝门淋巴结肿大行肝门淋巴结清扫术,将有肝门淋巴结转移的15例设为淋巴结转移组,无肝门淋巴结转移的13例设为非淋巴结转移组,对2组患者的无瘤生存期和总生存期情况进行比较。结果淋巴结转移组生存2～13个月,中位生存期4个月,无瘤生存1～8个月,无瘤中位生存期3个月;非淋巴结转移组患者生存3～69个月,中位生存期11个月,无瘤生存2～32个月,无瘤中位生存期7个月。2组患者的无瘤生存期和总生存期有显著性差异(χ2=5.786,P=0.038;χ2=3.963,P=0.045)。结论伴有肝门淋巴结转移的原发性肝癌门静脉癌栓患者的手术疗效较差,即使行肝门淋巴结清扫也不能达到根治效果,并不能显著提高该病人的生存期。
Objective To investigate the efficacy of partial hepatectomy for portal vein hepatocellular carcinoma （HCC） thrombus complicated with portal lymph node metastasis. Methods From January 2001 to December 2003, a total of 28 cases of HCC complicated with portal vein tumor thrombus underwent surgery in our hospital. Lymph nodes resection was carried out during the operation because of swollen portal lymph nodes. Among the patients, portal lymph node metastasis was detected in 15 cases （metastasis group） ,and the other 13 patients showed no portal lymph node metastasis （non-metastasis group）. The tumor-free survival time and total survival time was compared between the two groups. Results In the metastasis group, the total survival time ranged from 2 to 13 months （medium, 4 months）, and tumor-free survival time was 1 to 8 months with a medium of 3 months. While in the non-metastasis group, the medium total survival time was 11 months （ranged from 3 to 69 months） , and medium tumor-free survival time was 7 months （ ranged from 2 to 32 months）. Significant difference existed between the two groups in the total or tumor-free survival time （X2 = 5. 786, P = 0. 038 ; X2 = 3. 963, P = 0. 045 ）. Conclusions Partial hepatectomy is not effective for patients with primary HCC with portal vein tumor thrombus and portal lymph node metastasis. Even if regional lymph node dissection is performed, the patient＇s survival time cannot be significantly improved.
出处
《中国微创外科杂志》
CSCD
2012年第8期687-689,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
原发性肝癌
门静脉癌栓
肝门淋巴结转移
Primary hepatocellular carcinoma
Portal vein tumor thrombus
Portal lymph node metastasis
