Effect of resection following downstaging of unresectable hepatocelluar carcinoma by transcatheter arterial chemoembolization

作     者：Shi Xian-jie Jin Xin Wang Mao-qiang Wei Li-xin Ye Hui-yi Liang Yu-rong Luo Ying Dong Jia-hong 

作者机构：Gen Hosp Chinese Peoples Liberat Army Dept Hepatobillary Surg Beijing 100853 Peoples R China Gen Hosp Chinese Peoples Liberat Army Dept Intervent Radiol Beijing 100853 Peoples R China Gen Hosp Chinese Peoples Liberat Army Dept Pathol Beijing 100853 Peoples R China Gen Hosp Chinese Peoples Liberat Army Dept Radiol Beijing 100853 Peoples R China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2012年第000卷第2期

页      面：197-202页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：hepatocellular carcinoma tumor downstaging transcatheter arterial chemoembolization hepatectomy 

摘      要：Background This retrospective study was undertaken to analyze the outcome of hepatic resection in fifty-two patients with unresectable hepatocellular carcinoma （HCC） between January 2004 and December *** Among these fifty-two patients,the mean diameter of the tumor was 7.9 cm （4.4-15.5 cm,median 8.5 cm） prior to the first transcatheter arterial chemoembolization （TACE）.After 1-6 times of TACE （median 2）,the median tumor diameter was reduced to 4.2 cm （0-8.4 cm） prior to *** duration between the last TACE treatment and sequential resection varied from one to six months （median 2.7 months）.Serum α-fetoprotein （AFP） levels were abnormal in thirty-eight out of the fifty-two *** AFP producing HCCs,AFP levels returned to normal （≤400 μg/L） in twenty-five out of thirty-eight *** segmentectomy,multiple hepatic segmentectomy or partial hepatic resection were performed in forty-five patients,two underwent extended left hemihepatectomy,and one underwent right posterior branch portal vein *** patient received a right hemihepatectomy and three had left *** Complete tumor radiological response （CR） occurred in five patients （9.6%）.There were three cases of perioperative mortality in the fifty-two patients （5.8%）.One patient underwent salvaged orthotopic liver transplantation,and twenty-one patients observed tumor recurrence within two *** 1-,3- and 5-year survival rates of the fifty-two patients were 77.0% （n=40）,55.0% （n=29）,and 52.0% （n=28）,*** median survival time after surgery was 49 months （95% confidence interval 7.5-52.7 months）.Conclusions TACE treatment provides a better chance for HCC resection in patients initially diagnosed with unresectable ***,liver resection should be performed once the tumor is downstaged to be compatible for successful resection