Sequential and Combined Therapy after Hepatoma Excision(Report of 3 Cases and Literature Review)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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雷建勇 , 严律南 , 王文涛 , 徐明清 , 杨家印

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Keywords：

肝癌; 预防复发; 序贯综合治疗; 疗效; 肝移植; 肝癌切除; 肝癌治疗

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目的探讨肝癌手术切除后的序贯综合治疗,以达到有效防治肿瘤复发的目的。方法从我科收治的肝癌患者中挑选3例手术治疗后进行序贯综合治疗并取得良好效果病例，对其临床资料进行分析，从中获取有关肝癌术后治疗的经验。结果3例肝癌患者在我科手术后接受了积极的预防复发措施，虽最终均出现复发，但对待复发的肿瘤均采取积极的应对措施，获得了长期生存。结论对于肝癌手术切除后的患者进行积极的序贯性综合治疗有较好的临床意义，鼓励对术后复发病例进行积极序贯综合治疗。

Citation： 雷建勇,严律南,王文涛,徐明清,杨家印. Sequential and Combined Therapy after Hepatoma Excision(Report of 3 Cases and Literature Review). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(6): 654-656. doi: Copy

1.	Llovet JM, Fuster J, Bruix J. Intentiontotreat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation [J]. Hepatology, 1999, 30(6): 14341440.
2.	Choi GH, Kim DH, Kang CM, et al. Is preoperative transarterial chemoembolization needed for a resectable hepatocellular carcinoma? [J]. World J Surg, 2007, 31(12): 23702377.
3.	Chen XP, Hu DY, Zhang ZW, et al. Role of mesohepatectomy with or without transcatheter arterial chemoembolization for large centrally located hepatocellular carcinoma [J]. Dig Surg, 2007, 24(3): 208213．.
4.	Chau GY, Lui WY, Tsay SH, et al. Postresectional adjuvant intraportal chemotherapy in patients with hepatocellular carcinoma: a casecontrol study [J]. Ann Surg Oncol, 2006, 13(10): 13291337.
5.	Marelli L, Stigliano R, Triantos C, et al. Treatment outcomes for hepatocellular carcinoma using chemoembolization in combination with other therapies [J]. Cancer Treat Rev, 2006, 32(8): 594606.
6.	Jeong S, Aikata H, Katamura Y, et al. Lowdose intermittent interferonalpha therapy for HCVrelated liver cirrhosis after curative treatment of hepatocellular carcinoma [J]. World J Gastroenterol, 2007, 13(39): 51885195.
7.	Lo CM, Hu CL, Chan SC, et al. A randomized controlled trial of postoperative adjuvant interferon therapy after resection of hepatocellular carcinoma [J]. Ann Surg, 2007, 245(6): 831842．.
8.	Dawson LA, Eccles C, Bissonnette JP, et al. Accuracy of daily image guidance for hypofractionated liver radiotherapy with active breathing control [J]. Int J Radiat Oncol Biol Phys, 2005, 62(4): 12471252.
9.	吴孟超. 中医药在肝癌防治中的作用、地位和存在的问题 [J]．中西医结合学报, 2003, 1(3): 163164.
10.	Mizuta T, Ozaki I, Eguchi Y, et al. The effect of menatetrenone, a vitamin K2 analog, on disease recurrence and survival in patients with hepatocellular carcinoma after curative treatment: a pilot study [J]. Cancer, 2006, 106(4): 867872.
11.	李瑜元. 原发性肝癌的非手术治疗 [J]．实用医学杂志, 2003, 19(3): 231233．.
12.	樊嘉，黄成. 原发性肝癌外科治疗的进展 [J]. 中国普外基础与临床杂志, 2009, 16(4): 257260.
13.	Ueno S, Kubo F, Sakoda M, et al. Efficacy of anatomic resection vs nonanatomic resection for small nodular hepatocellular carcinoma based on gross classification [J]. J Hepatobiliary Pancreat Surg, 2008, 15(5): 493500.
14.	Adam R, Del Gaudio M. Evolution of liver transplantation for hepatocellular carcinoma [J]. J Hepatol, 2003, 39(6): 888895.
15.	Sugawara Y, Kokudo N. Surgical treatment of hepatocellular carcinoma: comparison of resection and transplantation [J]. Oncology, 2008, 75 Suppl 1: 119123.
16.	杨广顺, 吴志全, 吴孟超. 原发性肝癌的规范化综合治疗 [J]．中华外科杂志， 2001， 39(10)： 742744.
17.	Seo DD, Lee HC, Jang MK, et al. Preoperative portal vein embolization and surgical resection in patients with hepatocellular carcinoma and small future liver remnant volume: comparison with transarterial chemoembolization [J]. Ann Surg Oncol, 2007, 14(12): 35013509.
18.	Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolization for major liver resection: a metaanalysis [J]. Ann Surg, 2008, 247(1): 4957.
19.	Livraghi T, Solbiati L, Meloni MF, et al. Treatment of focal liver tumors with percutaneous radiofrequency ablation: complications encountered in a multicenter study [J]. Radiology, 2003, 226(2): 441451.
20.	姚和瑞, 谢德荣, 滕虹, 等. 高强度聚焦超声热疗治疗晚期原发性肝癌疗效观察 [J]. 新医学, 2003, 34(5)： 303304.
21.	Lee J, Park JO, Kim WS, et al. Phase II study of doxorubicin and cisplatin in patients with metastatic hepatocellular carcinoma [J]. Cancer Chemother Pharmacol, 2004, 54(5): 385390.
22.	Ikeda M, Okusaka T, Ueno H, et al. A phase II trial of continuous infusion of 5fluorouracil, mitoxantrone, and cisplatin for metastatic hepatocellular carcinoma [J]. Cancer, 2005, 103(4): 756762.
23.	Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma [J]. Lancet, 2003, 362(9399): 19071917.

1. Llovet JM, Fuster J, Bruix J. Intentiontotreat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation [J]. Hepatology, 1999, 30(6): 14341440.
2. Choi GH, Kim DH, Kang CM, et al. Is preoperative transarterial chemoembolization needed for a resectable hepatocellular carcinoma? [J]. World J Surg, 2007, 31(12): 23702377.
3. Chen XP, Hu DY, Zhang ZW, et al. Role of mesohepatectomy with or without transcatheter arterial chemoembolization for large centrally located hepatocellular carcinoma [J]. Dig Surg, 2007, 24(3): 208213．.
4. Chau GY, Lui WY, Tsay SH, et al. Postresectional adjuvant intraportal chemotherapy in patients with hepatocellular carcinoma: a casecontrol study [J]. Ann Surg Oncol, 2006, 13(10): 13291337.
5. Marelli L, Stigliano R, Triantos C, et al. Treatment outcomes for hepatocellular carcinoma using chemoembolization in combination with other therapies [J]. Cancer Treat Rev, 2006, 32(8): 594606.
6. Jeong S, Aikata H, Katamura Y, et al. Lowdose intermittent interferonalpha therapy for HCVrelated liver cirrhosis after curative treatment of hepatocellular carcinoma [J]. World J Gastroenterol, 2007, 13(39): 51885195.
7. Lo CM, Hu CL, Chan SC, et al. A randomized controlled trial of postoperative adjuvant interferon therapy after resection of hepatocellular carcinoma [J]. Ann Surg, 2007, 245(6): 831842．.
8. Dawson LA, Eccles C, Bissonnette JP, et al. Accuracy of daily image guidance for hypofractionated liver radiotherapy with active breathing control [J]. Int J Radiat Oncol Biol Phys, 2005, 62(4): 12471252.
9. 吴孟超. 中医药在肝癌防治中的作用、地位和存在的问题 [J]．中西医结合学报, 2003, 1(3): 163164.
10. Mizuta T, Ozaki I, Eguchi Y, et al. The effect of menatetrenone, a vitamin K2 analog, on disease recurrence and survival in patients with hepatocellular carcinoma after curative treatment: a pilot study [J]. Cancer, 2006, 106(4): 867872.
11. 李瑜元. 原发性肝癌的非手术治疗 [J]．实用医学杂志, 2003, 19(3): 231233．.
12. 樊嘉，黄成. 原发性肝癌外科治疗的进展 [J]. 中国普外基础与临床杂志, 2009, 16(4): 257260.
13. Ueno S, Kubo F, Sakoda M, et al. Efficacy of anatomic resection vs nonanatomic resection for small nodular hepatocellular carcinoma based on gross classification [J]. J Hepatobiliary Pancreat Surg, 2008, 15(5): 493500.
14. Adam R, Del Gaudio M. Evolution of liver transplantation for hepatocellular carcinoma [J]. J Hepatol, 2003, 39(6): 888895.
15. Sugawara Y, Kokudo N. Surgical treatment of hepatocellular carcinoma: comparison of resection and transplantation [J]. Oncology, 2008, 75 Suppl 1: 119123.
16. 杨广顺, 吴志全, 吴孟超. 原发性肝癌的规范化综合治疗 [J]．中华外科杂志， 2001， 39(10)： 742744.
17. Seo DD, Lee HC, Jang MK, et al. Preoperative portal vein embolization and surgical resection in patients with hepatocellular carcinoma and small future liver remnant volume: comparison with transarterial chemoembolization [J]. Ann Surg Oncol, 2007, 14(12): 35013509.
18. Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolization for major liver resection: a metaanalysis [J]. Ann Surg, 2008, 247(1): 4957.
19. Livraghi T, Solbiati L, Meloni MF, et al. Treatment of focal liver tumors with percutaneous radiofrequency ablation: complications encountered in a multicenter study [J]. Radiology, 2003, 226(2): 441451.
20. 姚和瑞, 谢德荣, 滕虹, 等. 高强度聚焦超声热疗治疗晚期原发性肝癌疗效观察 [J]. 新医学, 2003, 34(5)： 303304.
21. Lee J, Park JO, Kim WS, et al. Phase II study of doxorubicin and cisplatin in patients with metastatic hepatocellular carcinoma [J]. Cancer Chemother Pharmacol, 2004, 54(5): 385390.
22. Ikeda M, Okusaka T, Ueno H, et al. A phase II trial of continuous infusion of 5fluorouracil, mitoxantrone, and cisplatin for metastatic hepatocellular carcinoma [J]. Cancer, 2005, 103(4): 756762.
23. Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma [J]. Lancet, 2003, 362(9399): 19071917.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Sequential and Combined Therapy after Hepatoma Excision(Report of 3 Cases and Literature Review)

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