肝癌合并门静脉癌栓患者术后肝动脉化疗栓塞术联合门静脉化疗的有效性及安全性
|
摘要
目的:探讨肝癌合并门静脉癌栓(PVTT)患者术后辅助肝动脉化疗栓塞术(TACE)联合门静脉化疗(PVC)的有效性及安全性。方法:回顾性分析2010年1月—2016年1月收治的经手术治疗的119例肝癌合并PVTT患者临床资料,其中64例术中放置门静脉化疗泵,术后行TACE治疗及通过门静脉化疗泵行PVC(TACE+PVC组),5 5例术中未放置门静脉化疗泵,术后行单纯T A C E (T A C E组)。观察两组术后生存及并发症情况。结果:TACE+PVC组与TACE组中位无瘤生存期及中位生存期分别为13.3个月vs.6.8个月、19.5个月vs.12.5个月;术后0.5、1、2、3年的无瘤生存率及71.9%vs.52.9%、57.5%vs.26.7%、16.4%vs.8.2%、6.9%vs.2.1%,总生存率分别为90.5%vs.89.1%、69.5%vs.50.4%、37.9%vs.12.1%、22.4%vs.8.1%,TACE+PVC组的无瘤生存率与总生存率均明显优于TACE组(P=0.004、P=0.001)。统计分析显示,术后治疗方式是患者术后生存时间的独立影响因素之一(P<0.05)。两组术后各并发症发生率差异无统计科学意义(均P>0.05)。结论:术后辅助TACE联合PVC治疗合并PVTT的肝癌患者安全有效,且效果优于单纯TACE治疗。
Objective: To investigate the efficacy and safety of postoperative adjuvant transcatheter arterial chemoembolization(TACE) plus portal vein chemotherapy(PVC) for patients with hepatocellular carcinoma(HCC) and portal vein tumor thrombus(PVTT).Methods: The clinical data of 119 HCC patients associated with PVTT undergoing surgical treatment from January 2010 to January 2016 were retrospectively analyzed. Of the patients, 64 cases underwent placement of an intravenous chemotherapy pump during operation, and then underwent TACE and PVC through the intravenous chemotherapy pump after operation(TACE+PVC group), and 55 cases did not undergo intravenous chemotherapy pump placement and underwent TACE along after operation(TACE group). The postoperative survival and incidence of postoperative complications of the two groups of patients were observed.Results: In TACE+PVC group and TACE group, the median disease-free survival(DFS) time and median overall survival(OS) time were 13.3 months vs.6.8 months, and 19.5 months vs.12.5 months, and the 0.5-, 1, 2, and 3-year DFS rates were 71.9% vs.52.9%, 57.5% vs. 26.7%, 16.4% vs.8.2% and 6.9% vs. 2.1%, and OS rates were 90.5% vs. 89.1%, 69.5% vs. 50.4%, 37.9% vs. 12.1% and 22.4% vs. 8.1%, respectively. The median tumor-free survival and median survival time in the TACE group were 6.8 months and 12.5 months, respectively. Both DFS rate and OS rate of TACE+PVC group were significantly higher than those of TACE group(P=0.004 and P=0.001). Results of statistical analysis showed that postoperative treatment method was one of the independent risk factors for postoperative survival of the patients(P<0.05). There were no significant differences in incidence of each specific postoperative complication between the two groups(all P>0.05). Conclusion: Postoperative adjuvant TACE plus PVC is safe and effective for patients with HCC and PVTT, and its efficacy is superior to that of TACE alone.
Objective: To investigate the efficacy and safety of postoperative adjuvant transcatheter arterial chemoembolization(TACE) plus portal vein chemotherapy(PVC) for patients with hepatocellular carcinoma(HCC) and portal vein tumor thrombus(PVTT).Methods: The clinical data of 119 HCC patients associated with PVTT undergoing surgical treatment from January 2010 to January 2016 were retrospectively analyzed. Of the patients, 64 cases underwent placement of an intravenous chemotherapy pump during operation, and then underwent TACE and PVC through the intravenous chemotherapy pump after operation(TACE+PVC group), and 55 cases did not undergo intravenous chemotherapy pump placement and underwent TACE along after operation(TACE group). The postoperative survival and incidence of postoperative complications of the two groups of patients were observed.Results: In TACE+PVC group and TACE group, the median disease-free survival(DFS) time and median overall survival(OS) time were 13.3 months vs.6.8 months, and 19.5 months vs.12.5 months, and the 0.5-, 1, 2, and 3-year DFS rates were 71.9% vs.52.9%, 57.5% vs. 26.7%, 16.4% vs.8.2% and 6.9% vs. 2.1%, and OS rates were 90.5% vs. 89.1%, 69.5% vs. 50.4%, 37.9% vs. 12.1% and 22.4% vs. 8.1%, respectively. The median tumor-free survival and median survival time in the TACE group were 6.8 months and 12.5 months, respectively. Both DFS rate and OS rate of TACE+PVC group were significantly higher than those of TACE group(P=0.004 and P=0.001). Results of statistical analysis showed that postoperative treatment method was one of the independent risk factors for postoperative survival of the patients(P<0.05). There were no significant differences in incidence of each specific postoperative complication between the two groups(all P>0.05). Conclusion: Postoperative adjuvant TACE plus PVC is safe and effective for patients with HCC and PVTT, and its efficacy is superior to that of TACE alone.
引文
[1]Torre LA,Bray F,Siegel RL,et al.Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.doi:10.3322/caac.21262.
[2]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.doi:10.3322/caac.21338.
[3]Zhang ZM,Lai EC,Zhang C,et al.The strategies for treating primary hepatocellular carcinoma with portal vein tumor thrombus[J].Int J Surg,2015,20:8-16.doi:10.1016/j.ijsu.2015.05.009.
[4]Yang T,Lin C,Zhai J,et al.Surgical resection for advanced hepatocellular carcinoma according to Barcelona Clinic Liver Cancer(BCLC)staging[J].J Cancer Res Clin Oncol,2012,138(7):1121-1129.doi:10.1007/s00432-012-1188-0.
[5]Luo J,Guo RP,Lai EC,et al.Transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein tumor thrombosis:a prospective comparative study[J].Ann Surg Oncol,2011,18(2):413-420.doi:10.1245/s10434-010-1321-8.
[6]Shuqun C,Mengchao W,Han C,et al.Tumor thrombus types influence the prognosis of hepatocellular carcinoma with the tumor thrombi in the portal vein[J].Hepatogastroenterology,2007,54(74):499-502.
[7]杜锡林,谭凯,阴继凯,等.肝切除、肝动脉化疗栓塞、微波固化联合门静脉化疗对巨块型肝细胞癌的疗效分析[J].中华肝胆外科杂志,2015,21(12):853-854.doi:10.3760/cma.j.issn.1007-8118.2015.12.018.Du XL,Tan K,Yin JK,et al.Efficacy analysis of hepatectomy,transarterial chemoembolization,and microwave coagulation plus portal vein chemotherapy in treatment of huge hepatocellular carcinoma[J].Chinese Journal of Hepatobiliary Surgery,2015,21(12):853-854.doi:10.3760/cma.j.issn.1007-8118.2015.12.018.
[8]Ye JZ,Wang YY,Bai T,et al.Surgical resection for hepatocellular carcinoma with portal vein tumor thrombus in the Asia-Pacific region beyond the Barcelona Clinic Liver Cancer treatment algorithms:a review and update[J].Oncotarget,2017,8(54):93258-93278.doi:10.18632/oncotarget.18735.
[9]孙居仙,石洁,程树群.肝癌合并门静脉癌栓诊治难点及对策[J].中国实用外科杂志,2016,36(6):614-617.10.7504/CJPS.ISSN1005-2208.2016.06.07.Sun JX,Shi J,Cheng SQ.Difficulties and countermeasures of diagnosis and treatment for hepatocellular carcinoma with portal venous tumor thrombus[J].Chinese Journal of Practical Surgery,2016,36(6):614-617.10.7504/CJPS.ISSN1005-2208.2016.06.07.
[10]Forner A,Reig M,Bruix J.Hepatocellular carcinoma[J].Lancet,2018,391(10127):1301-1314.doi:10.1016/S0140-6736(18)30010-2.
[11]中华人民共和国卫生和计划生育委员会医政医管局.原发性肝癌诊疗规范(2017年版)[J].中华肝脏病杂志,2017,25(12):886-895.doi:10.3760/cma.j.issn.1007-3418.2017.12.002.Bureau of Medical Administration,National Health and Family Planning Committee.Diagnosis,management,and treatment of hepatocellular carcinoma(V2017)[J].Chinese Journal of Hepatology,2017,25(12):886-895.doi:10.3760/cma.j.issn.1007-3418.2017.12.002.
[12]代柏树,杨振宇,杜锡林,等.肝细胞癌合并门静脉癌栓的治疗进展[J].现代肿瘤医学,2018,26(10):1619-1623.doi:10.3969/j.issn.1672-4992.2018.10.036.Dai BS,Yang ZY,Du XL,et al.Recent advances on the treatment of hepatocellular carcinoma with portal vein tumor thrombus[J]Journal of Modern Oncology,2018,26(10):1619-1623.doi:10.3969/j.issn.1672-4992.2018.10.036.
[13]Chen XP,Qiu FZ,Wu ZD,et al.Effects of location and extension of portal vein tumor thrombus on long-term outcomes of surgical treatment for hepatocellular carcinoma[J].Ann Surg Oncol,2006,13(7):940-946.doi:10.1245/ASO.2006.08.007.
[14]Li Q,Wang J,Sun Y,et al.Efficacy of postoperative transarterial chemoembolization and portal vein chemotherapy for patients with hepatocellular carcinoma complicated by portal vein tumor thrombosis--a randomized study[J].World J Surg,2006,30(11):2004-2011.doi:10.1007/s00268-006-0271-6.
[15]童颖,杨甲梅.原发性肝癌的门静脉化疗进展[J].中国实用外科杂志,2005,25(2):116-118.Tong Y,Yang JM.Advances in portal vein chemotherapy for primary liver cancer[J].Chinese Journal of Practical Surgery,2005,25(2):116-118.
[16]江海中,邓新,钟永富.肝癌合并门静脉癌栓的TACE治疗[J].中国普通外科杂志,2015,24(1):116-120.doi:10.3978/j.issn.1005-6947.2015.01.022.Jiang HZ,Deng X,Zhong YF,et al.TACE treatment for liver cancer with portal vein tumor thrombus[J].Chinese Journal of General Surgery,2015,24(1):116-120.d o i:10.3978/j.issn.1005-6947.2015.01.022.
[17]吴晓健,罗放,王济明,等.肝癌术后TACE的抗复发作用[J].激光杂志,2011,32(4):58-60.doi:10.3969/j.issn.0253-2743.2011.04.033.Wu XJ,Luo F,Wang JM,et al.The effect and utilization of TACEon intrahepatic recurrence after hepatic resection for hepatocellular carcinoma[J].Laser Journal,2011,32(4):58-60.doi:10.3969/j.issn.0253-2743.2011.04.033.
[18]Jiang JF,Lao YC,Yuan BH,et al.Treatment of hepatocellular carcinoma with portal vein tumor thrombus:advances and challenges[J].Oncotarget,2017,8(20):33911-33921.doi:10.18632/oncotarget.15411.
[19]庄建彬,王毅军,杜智,等.肝动脉插管化疗栓塞联合门静脉化疗对肝细胞癌患者术后生存期的影响[J].中华肝胆外科杂志,2010,16(8):579-581.doi:10.3760/cma.j.issn.1007-8118.2010.08.007.Zhuang JB,Wang YJ,Du Z,et al.Effects of transcatheter arterial chemoembolization in combination with portal vein chemotherapy on survival of patients after resection of hepatocellular carcinoma[J]Chinese Journal of Hepatobiliary Surgery,2010,16(8):579-581.doi:10.3760/cma.j.issn.1007-8118.2010.08.007.
[20]吕昕亮,张坤,朱锦德,等.门静脉化疗栓塞预防肝癌切除术后复发的临床分析[J].中华肝胆外科杂志,2012,18(1):15-18.doi:10.3760/cma.j.issn.1007-8118.2012.01.005.Lu XL,Zhang K,Zhu JD,et al.Adjuvant portal vein chemoembolization in partial hepatectomy for hepatocellular carcinoma[J]Chinese Journal of Hepatobiliary Surgery,2012,18(1):15-18.doi:10.3760/cma.j.issn.1007-8118.2012.01.005.
[21]李成军,鲁守堂.再次手术切除辅以门静脉化疗治疗肝癌术后复发[J].中国普通外科杂志,2015,24(1):136-139.doi:10.3978/j.issn.1005-6947.2015.01.027.Li CJ,Lu ST.Repeat surgical resection and adjuvant portal vein chemotherapy for postoperative recurrent hepatocellular carcinoma[J].Chinese Journal of General Surgery,2015,24(1):136-139.doi:10.3978/j.issn.1005-6947.2015.01.027.
[22]杨庆岩.对肝癌术后复发患者采用不同治疗方案的效果比较[J].中国普通外科杂志,2014,23(7):1002-1004.doi:10.7659/j.issn.1005-6947.2014.07.030.Yang QY.Results of different therapeutic methods for postoperative recurrence of hepatic cancer[J]Chinese Journal of General Surgery,2014,23(7):1002-1004.doi:10.7659/j.issn.1005-6947.2014.07.030.
[23]吴力群,王祖森,胡维昱,等.528例原发性肝细胞癌患者肝切除术后1年生存分析[j].中华普通外科杂志,2012,27(2):92-95.doi:10.3760/cma.j.issn.1007-631X.2012.02.002.Wu LQ,Wang ZS,Hu WY,et al.Analysis on factors influencing one-year-survival of hepatocellular carcinoma patients after hepatectomy[J]Zhong Hua Pu Tong Wai Ke Za Zhi,2012,27(2):92-95.doi:10.3760/cma.j.issn.1007-631X.2012.02.002.
[24]郑盛,唐映梅,尤丽英,等.双途径化疗治疗肝癌并发门静脉癌栓患者对预后的影响[J].实用肝脏病杂志,2013,16(4):351-353.doi:10.3969/j.issn.1672-5069.2013.04.021.Zheng S,Tang YM,You LY,et al.A three year-followed up of patients with hepatocellular carcinoma complicated by portal vein tumor;thrombus receiving TACE and PVC after resection of tumors[J]Journal of Clinical Hepatology,2013,16(4):351-353.doi:10.3969/j.issn.1672-5069.2013.04.021.
[25]荚卫东,刘文斌.《肝细胞癌合并门静脉癌栓多学科诊治中国专家共识(2016年版)》解读[J].中国普通外科杂志,2017,26(7):815-820.doi:10.3978/j.issn.1005-6947.2017.07.001.Jia WD,Liu WB.Interpretation of Chinese Expert Consensus on Multidisciplinary Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus(2016 edition)[J].Chinese Journal of General Surgery,2017,26(7):815-820.doi:10.3978/j.issn.1005-6947.2017.07.001.
[26]Fan J,Zhou J,Wu ZQ,et al.Efficacy of different treatment strategies for hepatocellular carcinoma with portal vein tumor thrombosis[J].World J Gastroenterol,2005,11(8):1215-1219.
[27]廖旺军,石敏,郑航,等.经皮化疗泵植入门静脉化疗治疗结直肠癌肝转移的临床观察[J].南方医科大学学报,2008,28(2):282-283.doi:10.3321/j.issn:1673-4254.2008.02.040.Liao WJ,Shi M,Zheng H,et al.Effect of percutaneous chemotherapy pump placement for portal vein chemotherapy on hepatic metastasis of colorectal cancer[J].Journal of Southern M e d i c a l U n i v e r s i t y,2008,28(2):282-283.d o i:10.3321/j.issn:1673-4254.2008.02.040.
[28]石好岭,庞志刚,尚闯.门静脉泵灌注化疗预防肝癌术后复发的作用[J].肿瘤基础与临床,2011,24(1):23-24.doi:10.3969/j.issn.1673-5412.2011.01.010.Shi HL,Pang ZG,Shang C.The Preventive Effect of Portal Vein Chemotherapy on Postoperative Recurrence of Hepatocellular Carcinoma[J].Journal of Basic and Clinical Oncology,2011,24(1):23-24.doi:10.3969/j.issn.1673-5412.2011.01.010.
[29]Li JQ,Zhang YQ,Zhang WZ,et al.Randomized study of chemoembolization as an adjuvant therapy for primary liver carcinoma after hepatectomy[J].J Cancer Res Clin Oncol,1995,121(6):364-366.
[30]Shi M,Zhang CQ,Zhang YQ,et al.Micrometastases of solitary hepatocellular carcinoma and appropriate resection margin[J].World J Surg,2004,28(4):376-381.doi:10.1007/s00268-003-7308-x.
[2]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.doi:10.3322/caac.21338.
[3]Zhang ZM,Lai EC,Zhang C,et al.The strategies for treating primary hepatocellular carcinoma with portal vein tumor thrombus[J].Int J Surg,2015,20:8-16.doi:10.1016/j.ijsu.2015.05.009.
[4]Yang T,Lin C,Zhai J,et al.Surgical resection for advanced hepatocellular carcinoma according to Barcelona Clinic Liver Cancer(BCLC)staging[J].J Cancer Res Clin Oncol,2012,138(7):1121-1129.doi:10.1007/s00432-012-1188-0.
[5]Luo J,Guo RP,Lai EC,et al.Transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein tumor thrombosis:a prospective comparative study[J].Ann Surg Oncol,2011,18(2):413-420.doi:10.1245/s10434-010-1321-8.
[6]Shuqun C,Mengchao W,Han C,et al.Tumor thrombus types influence the prognosis of hepatocellular carcinoma with the tumor thrombi in the portal vein[J].Hepatogastroenterology,2007,54(74):499-502.
[7]杜锡林,谭凯,阴继凯,等.肝切除、肝动脉化疗栓塞、微波固化联合门静脉化疗对巨块型肝细胞癌的疗效分析[J].中华肝胆外科杂志,2015,21(12):853-854.doi:10.3760/cma.j.issn.1007-8118.2015.12.018.Du XL,Tan K,Yin JK,et al.Efficacy analysis of hepatectomy,transarterial chemoembolization,and microwave coagulation plus portal vein chemotherapy in treatment of huge hepatocellular carcinoma[J].Chinese Journal of Hepatobiliary Surgery,2015,21(12):853-854.doi:10.3760/cma.j.issn.1007-8118.2015.12.018.
[8]Ye JZ,Wang YY,Bai T,et al.Surgical resection for hepatocellular carcinoma with portal vein tumor thrombus in the Asia-Pacific region beyond the Barcelona Clinic Liver Cancer treatment algorithms:a review and update[J].Oncotarget,2017,8(54):93258-93278.doi:10.18632/oncotarget.18735.
[9]孙居仙,石洁,程树群.肝癌合并门静脉癌栓诊治难点及对策[J].中国实用外科杂志,2016,36(6):614-617.10.7504/CJPS.ISSN1005-2208.2016.06.07.Sun JX,Shi J,Cheng SQ.Difficulties and countermeasures of diagnosis and treatment for hepatocellular carcinoma with portal venous tumor thrombus[J].Chinese Journal of Practical Surgery,2016,36(6):614-617.10.7504/CJPS.ISSN1005-2208.2016.06.07.
[10]Forner A,Reig M,Bruix J.Hepatocellular carcinoma[J].Lancet,2018,391(10127):1301-1314.doi:10.1016/S0140-6736(18)30010-2.
[11]中华人民共和国卫生和计划生育委员会医政医管局.原发性肝癌诊疗规范(2017年版)[J].中华肝脏病杂志,2017,25(12):886-895.doi:10.3760/cma.j.issn.1007-3418.2017.12.002.Bureau of Medical Administration,National Health and Family Planning Committee.Diagnosis,management,and treatment of hepatocellular carcinoma(V2017)[J].Chinese Journal of Hepatology,2017,25(12):886-895.doi:10.3760/cma.j.issn.1007-3418.2017.12.002.
[12]代柏树,杨振宇,杜锡林,等.肝细胞癌合并门静脉癌栓的治疗进展[J].现代肿瘤医学,2018,26(10):1619-1623.doi:10.3969/j.issn.1672-4992.2018.10.036.Dai BS,Yang ZY,Du XL,et al.Recent advances on the treatment of hepatocellular carcinoma with portal vein tumor thrombus[J]Journal of Modern Oncology,2018,26(10):1619-1623.doi:10.3969/j.issn.1672-4992.2018.10.036.
[13]Chen XP,Qiu FZ,Wu ZD,et al.Effects of location and extension of portal vein tumor thrombus on long-term outcomes of surgical treatment for hepatocellular carcinoma[J].Ann Surg Oncol,2006,13(7):940-946.doi:10.1245/ASO.2006.08.007.
[14]Li Q,Wang J,Sun Y,et al.Efficacy of postoperative transarterial chemoembolization and portal vein chemotherapy for patients with hepatocellular carcinoma complicated by portal vein tumor thrombosis--a randomized study[J].World J Surg,2006,30(11):2004-2011.doi:10.1007/s00268-006-0271-6.
[15]童颖,杨甲梅.原发性肝癌的门静脉化疗进展[J].中国实用外科杂志,2005,25(2):116-118.Tong Y,Yang JM.Advances in portal vein chemotherapy for primary liver cancer[J].Chinese Journal of Practical Surgery,2005,25(2):116-118.
[16]江海中,邓新,钟永富.肝癌合并门静脉癌栓的TACE治疗[J].中国普通外科杂志,2015,24(1):116-120.doi:10.3978/j.issn.1005-6947.2015.01.022.Jiang HZ,Deng X,Zhong YF,et al.TACE treatment for liver cancer with portal vein tumor thrombus[J].Chinese Journal of General Surgery,2015,24(1):116-120.d o i:10.3978/j.issn.1005-6947.2015.01.022.
[17]吴晓健,罗放,王济明,等.肝癌术后TACE的抗复发作用[J].激光杂志,2011,32(4):58-60.doi:10.3969/j.issn.0253-2743.2011.04.033.Wu XJ,Luo F,Wang JM,et al.The effect and utilization of TACEon intrahepatic recurrence after hepatic resection for hepatocellular carcinoma[J].Laser Journal,2011,32(4):58-60.doi:10.3969/j.issn.0253-2743.2011.04.033.
[18]Jiang JF,Lao YC,Yuan BH,et al.Treatment of hepatocellular carcinoma with portal vein tumor thrombus:advances and challenges[J].Oncotarget,2017,8(20):33911-33921.doi:10.18632/oncotarget.15411.
[19]庄建彬,王毅军,杜智,等.肝动脉插管化疗栓塞联合门静脉化疗对肝细胞癌患者术后生存期的影响[J].中华肝胆外科杂志,2010,16(8):579-581.doi:10.3760/cma.j.issn.1007-8118.2010.08.007.Zhuang JB,Wang YJ,Du Z,et al.Effects of transcatheter arterial chemoembolization in combination with portal vein chemotherapy on survival of patients after resection of hepatocellular carcinoma[J]Chinese Journal of Hepatobiliary Surgery,2010,16(8):579-581.doi:10.3760/cma.j.issn.1007-8118.2010.08.007.
[20]吕昕亮,张坤,朱锦德,等.门静脉化疗栓塞预防肝癌切除术后复发的临床分析[J].中华肝胆外科杂志,2012,18(1):15-18.doi:10.3760/cma.j.issn.1007-8118.2012.01.005.Lu XL,Zhang K,Zhu JD,et al.Adjuvant portal vein chemoembolization in partial hepatectomy for hepatocellular carcinoma[J]Chinese Journal of Hepatobiliary Surgery,2012,18(1):15-18.doi:10.3760/cma.j.issn.1007-8118.2012.01.005.
[21]李成军,鲁守堂.再次手术切除辅以门静脉化疗治疗肝癌术后复发[J].中国普通外科杂志,2015,24(1):136-139.doi:10.3978/j.issn.1005-6947.2015.01.027.Li CJ,Lu ST.Repeat surgical resection and adjuvant portal vein chemotherapy for postoperative recurrent hepatocellular carcinoma[J].Chinese Journal of General Surgery,2015,24(1):136-139.doi:10.3978/j.issn.1005-6947.2015.01.027.
[22]杨庆岩.对肝癌术后复发患者采用不同治疗方案的效果比较[J].中国普通外科杂志,2014,23(7):1002-1004.doi:10.7659/j.issn.1005-6947.2014.07.030.Yang QY.Results of different therapeutic methods for postoperative recurrence of hepatic cancer[J]Chinese Journal of General Surgery,2014,23(7):1002-1004.doi:10.7659/j.issn.1005-6947.2014.07.030.
[23]吴力群,王祖森,胡维昱,等.528例原发性肝细胞癌患者肝切除术后1年生存分析[j].中华普通外科杂志,2012,27(2):92-95.doi:10.3760/cma.j.issn.1007-631X.2012.02.002.Wu LQ,Wang ZS,Hu WY,et al.Analysis on factors influencing one-year-survival of hepatocellular carcinoma patients after hepatectomy[J]Zhong Hua Pu Tong Wai Ke Za Zhi,2012,27(2):92-95.doi:10.3760/cma.j.issn.1007-631X.2012.02.002.
[24]郑盛,唐映梅,尤丽英,等.双途径化疗治疗肝癌并发门静脉癌栓患者对预后的影响[J].实用肝脏病杂志,2013,16(4):351-353.doi:10.3969/j.issn.1672-5069.2013.04.021.Zheng S,Tang YM,You LY,et al.A three year-followed up of patients with hepatocellular carcinoma complicated by portal vein tumor;thrombus receiving TACE and PVC after resection of tumors[J]Journal of Clinical Hepatology,2013,16(4):351-353.doi:10.3969/j.issn.1672-5069.2013.04.021.
[25]荚卫东,刘文斌.《肝细胞癌合并门静脉癌栓多学科诊治中国专家共识(2016年版)》解读[J].中国普通外科杂志,2017,26(7):815-820.doi:10.3978/j.issn.1005-6947.2017.07.001.Jia WD,Liu WB.Interpretation of Chinese Expert Consensus on Multidisciplinary Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus(2016 edition)[J].Chinese Journal of General Surgery,2017,26(7):815-820.doi:10.3978/j.issn.1005-6947.2017.07.001.
[26]Fan J,Zhou J,Wu ZQ,et al.Efficacy of different treatment strategies for hepatocellular carcinoma with portal vein tumor thrombosis[J].World J Gastroenterol,2005,11(8):1215-1219.
[27]廖旺军,石敏,郑航,等.经皮化疗泵植入门静脉化疗治疗结直肠癌肝转移的临床观察[J].南方医科大学学报,2008,28(2):282-283.doi:10.3321/j.issn:1673-4254.2008.02.040.Liao WJ,Shi M,Zheng H,et al.Effect of percutaneous chemotherapy pump placement for portal vein chemotherapy on hepatic metastasis of colorectal cancer[J].Journal of Southern M e d i c a l U n i v e r s i t y,2008,28(2):282-283.d o i:10.3321/j.issn:1673-4254.2008.02.040.
[28]石好岭,庞志刚,尚闯.门静脉泵灌注化疗预防肝癌术后复发的作用[J].肿瘤基础与临床,2011,24(1):23-24.doi:10.3969/j.issn.1673-5412.2011.01.010.Shi HL,Pang ZG,Shang C.The Preventive Effect of Portal Vein Chemotherapy on Postoperative Recurrence of Hepatocellular Carcinoma[J].Journal of Basic and Clinical Oncology,2011,24(1):23-24.doi:10.3969/j.issn.1673-5412.2011.01.010.
[29]Li JQ,Zhang YQ,Zhang WZ,et al.Randomized study of chemoembolization as an adjuvant therapy for primary liver carcinoma after hepatectomy[J].J Cancer Res Clin Oncol,1995,121(6):364-366.
[30]Shi M,Zhang CQ,Zhang YQ,et al.Micrometastases of solitary hepatocellular carcinoma and appropriate resection margin[J].World J Surg,2004,28(4):376-381.doi:10.1007/s00268-003-7308-x.