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頁籤選單縮合
題名 | Resection Margin in Preventing the Intrahepatic Recurrence after Resection of Hepatocellular Carcinoma=切除距離在預防肝細胞癌手術後肝內復發之影響 |
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作者 | 游朝慶; 楊美都; 吳建廷; 鄭隆賓; | 書刊名 | 臺灣外科醫學會雜誌 |
卷期 | 40:6 2007.11-12[民96.11-12] |
頁次 | 頁236-242 |
分類號 | 416.246 |
關鍵詞 | 復發; 切除距離; 肝細胞癌; Liver resection; Resection margin; Hepatocellular carcinoma; Intrahepatic recurrence; |
語文 | 英文(English) |
中文摘要 | 肝腫瘤的手術切除邊緣的重要性一直是爭議性的。本研究回溯性追蹤從1995年至2003年間手術切除肝細胞癌的202名患者,排除掉日後發生遠處轉移及切除邊緣爲零的患者,這些患者被分爲四組,分別爲切除邊緣小於0.5公分,0.5到0.99公分,1到1.99公分,及大於等於2公分。結果發現這四組之切除邊緣對存活及復發率的影響不大,當分爲切除邊緣小於或大於等於1公分兩族群,其對存活及復發率的影響同樣不顯著:但若分爲切除邊緣小於或大於等於0.5公分兩族群時,當切除邊緣小於0.5公分,相對就比較容易復發(34人,無病存活期中位數爲8.1個月,P=0.0371),而切除邊緣大於等於0.5公分的群組(168人,其無病存活期中位數爲18.6個月)。故結論是只要切除邊緣大於等於0.5公分就足以避免肝癌術後早期復發。 |
英文摘要 | Objectives: The extent of the liver resection margin (RM) for hepatocellular carcinoma (HCC) remains controversial. The aim of this study is to re-evaluate the optimal extent of resection. Methods: After exclusion of extrahepatic recurrence (n=12) or RM=0 cm (n=7), a retrospective review of 202 patients who underwent curative liver resection for primary HCC from May 1995 to Dec 2003 was conducted. These patients were divided into 4 groups according to the RM as<0.5 cm, 0.5-0.99cm, 1-1.99cm, and≥2cm, respectively. Then the same patients were re-divided into 2 groups as RM<1cm and≥1cm. We also analyzed the relationship of the 2 groups with RM<0.5cm and≥0.5cm from the same 202 patients. The difference of intrahepatic recurrence rate and patient survival rate were evaluated by the Kaplan-Meier method and compared by the log-rank test. Results: Both the RM among the 4 groups and RM<1cm vs. ≥1cm were not a significant factor related to patient survival or to the intrahepatic recurrence. Patients with a tumor RM less than 0.5cm had a poorer prognosis on intrahepatic recurrence (n=34, median value=8.1 months) than those with a RM greater than or equal to 0.5cm (n=168, median value=18.6 months) (P=0.0371). Conclusions: RM of greater or equal to 0.5cm is adequate with regard to the prevention of intrahepatic recurrence after resection of HCC. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。