早期肝细胞癌治疗方案的选择

任丹丹; 刘娜; 周路路; 张楠; 李春霞; 东冰; 徐光华

doi:10.3969/j.issn.1001-5256.2020.09.040

早期肝细胞癌治疗方案的选择

DOI: 10.3969/j.issn.1001-5256.2020.09.040

延安大学附属医院感染病科

基金项目:

延安市科技惠民计划项目(HM2009-04)；

详细信息

中图分类号: R735.7
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- 被引次数: 0
出版历程
- 出版日期: 2020-09-20

Selection of treatment regimens for early-stage hepatocellular carcinoma

Department of Infectious Diseases, Yan’an University Affiliated Hospital,

Research funding:

摘要

摘要:
肝细胞癌是世界上最常见的恶性肿瘤之一。目前肝细胞癌治疗方法主要包括外科治疗、局部区域治疗、放疗、系统治疗、中医药治疗等。介绍了外科治疗的适应证、手术方式以及术后辅助治疗等的选择优势。分析了肝移植的适应证及临床应用的前景,简述了目前各种技术成熟以及新兴消融技术的工作原理、最佳适应证以及技术优势。认为对于早期肝细胞癌的患者,充分了解每种治疗方案的优势及不足可以做出更准确的治疗方案。
- 癌,肝细胞 /
- 肝切除术 /
- 肝移植 /
- 消融技术
Abstract:
Hepatocellular carcinoma( HCC) is one of the most common malignant tumors in the world. At present,the treatment methods for HCC mainly include surgical treatment,local regional treatment,radiotherapy,systematic treatment,and traditional Chinese medicine treatment. This article introduces the indications for surgical treatment,surgical procedures,and the advantages of postoperative adjuvant therapy,analyzes the indications for liver transplantation and its future application in clinical practice,and describes the basic principles,optimal indications,and technical advantages of mature and new ablation techniques at present. It is pointed out that for patients with early-stage HCC,the advantages and shortcomings of each treatment regimen should be fully understood to select a precise treatment regimen.
- carcinoma,hepatocellular /
- hepatectomy /
- liver transplantation /
- ablation techniques

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参考文献(45)

[1] YU JJ,YAN WT,QUAN B,et al. Recommendations for EASL Clinical Practice Guidelines:Management of hepatocellular carcinoma(2018)[J]. J Clin Hepatol,2018,34(6):1183-1186.(in Chinese)余炯杰，严文韬，权冰，等．《2018年欧洲肝病学会临床实践指南:肝细胞癌的管理》推荐意见[J]．临床肝胆病杂志，2018,34(6):1183-1186.

[2] YOON YI,KIM KH,CHO HD,et al. Long-term perioperative outcomes of pure laparoscopic liver resection versus open liver resection for hepatocellular carcinoma:A retrospective study[J]. Surg Endosc,2020,34(2):796-805.

[3] DI SANDRO S,BAGNARDI V,NAJJAR M,et al. Minor laparoscopic liver resection for hepatocellular carcinoma is safer than minor open resection,especially for less compensated cirrhotic patients:Propensity score analysis[J]. Surg Oncol,2018,27(4):722-729.

[4] FENG X,SU Y,ZHENG S,et al. A double blinded prospective randomized trial comparing the effect of anatomic versus non-anatomic resection on hepatocellular carcinoma recurrence[J]. HPB(Oxford),2017,19(8):667-674.

[5] LI SQ,HUANG T,SHEN SL,et al. Anatomical versus nonanatomical liver resection for hepatocellular carcinoma exceeding Milan criteria[J]. Br J Surg,2017,104(1):118-127.

[6] TOMIMARU Y,EGUCHI H,MARUBASHI S,et al. Equivalent outcomes after anatomical and non-anatomical resection of small hepatocellular carcinoma in patients with preserved liver function[J]. Dig Dis Sci,2012,57(7):1942-1948.

[7] SHIMADA S,KAMIYAMA T,ORIMO T,et al. Long-term prognostic factors of patients with hepatocellular carcinoma who survive over 10 years after hepatectomy[J]. J Surg Oncol,2020,121(8):1209-1217.

[8] FENG AL,ZHU JK,YANG Y,et al. Repeated postoperative adjuvant TACE after curative hepatectomy improves outcomes of patients with HCC[J]. Minim Invasive Ther Allied Technol,2019.[Online ahead of print]

[9] WANG L,KE Q,DENG M,et al. Adjuvant transarterial chemoembolization for patients with hepatocellular carcinoma after radical hepatectomy:A real world study[J]. Scand J Gastroenterol,2019,54(11):1403-1411.

[10] ZOU H,ZHU CZ,WANG C,et al. Recurrence of barcelona clinic liver cancer stage a hepatocellular carcinoma after hepatectomy[J]. Am J Med Sci,2017,354(3):262-267.

[11] ZHU H,YE B,QIAO Z,et al. Hepatectomy combined with sorafenib in patients with intermediate-advanced hepatocellullar carcinoma[J]. J BUON,2019,24(4):1382-1389.

[12] PINYOL R,MONTAL R,BASSAGANYAS L,et al. Molecular predictors of prevention of recurrence in HCC with sorafenib as adjuvant treatment and prognostic factors in the phase 3STORM trial[J]. Gut,2019,68(6):1065-1075.

[13] Organ Transplantation Branch,Chinese Medical Doctor Association; Chinese Society of Organ Transplantation,Chinese Medical Association. The Chinese clinical practice guideline on liver transplantation for hepatocellular carcinoma(2018)[J]. J Clin Hepatol,2019,35(2):275-280.(in Chinese)中国医师协会器官移植医师分会，中华医学会器官移植学分会．中国肝癌肝移植临床实践指南(2018版)[J]．临床肝胆病杂志，2019,35(2):275-280.

[14] ZHANG HM,SHI YX,SUN LY,et al. Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation:A systematic review and meta-analysis[J]. Chin Med J(Engl),2019,132(13):1599-1609.

[15] WONG T,NG K,FUNG J,et al. Long-term survival outcome between living donor and deceased donor liver transplant for hepatocellular carcinoma:Intention-to-treat and propensity score matching analyses[J]. Ann Surg Oncol,2019,26(5):1454-1462.

[16] YOON YI,LEE SG. Living donor liver transplantation for hepatocellular carcinoma:An asian perspective[J]. Dig Dis Sci,2019,64(4):993-1000.

[17] HOFFMANN K,GANTEN T,GOTTHARDTP D,et al. Impact of neo-adjuvant Sorafenib treatment on liver transplantation in HCC patients-a prospective,randomized,double-blind,phase III trial[J]. BMC Cancer,2015,15:392.

[18] XING M,SAKARIA S,DHANASEKARAN R,et al. Bridging locoregional therapy prolongs survival in patients listed for liver transplant with hepatocellular carcinoma[J]. Cardiovasc Intervent Radiol,2017,40(3):410-420.

[19] LAI Q,VITALE A,IESARI S,et al. The Intention-to-treat effect of bridging treatments in the setting of milan criteria-in patients waiting for liver transplantation[J]. Liver Transpl,2019,25(7):1023-1033.

[20] GEISSLER EK,SCHNITZBAUER AA,ZLKE C,et al. Sirolimus use in liver transplant recipients with hepatocellular carcinoma:A randomized,multicenter,open-label phase 3 trial[J]. Transplantation,2016,100(1):116-125.

[21] GRIGG SE,SARRI GL,GOW PJ,et al. Systematic review with meta-analysis:Sirolimus-or everolimus-based immunosuppression following liver transplantation for hepatocellular carcinoma[J]. Aliment Pharmacol Ther,2019,49(10):1260-1273.

[22] HUANG L,LI GM,ZHU JY,et al. Efficacy of sorafenib after liver transplantation in patients with primary hepatic carcinoma exceeding the Milan criteria:A preliminary study[J]. Onco Targets Ther,2012,5:457-462.

[23] EBARA M,OHTO M,SUGIURA N,et al. Percutaneous ethanol injection for the treatment of small hepatocellular carcinoma. Study of 95 patients[J]. J Gastroenterol Hepatol,1990,5(6):616-626.

[24] OMATA M,CHENG AL,KOKUDO N,et al. Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma:A 2017 update[J]. Hepatol Int,2017,11(4):317-370.

[25] HU XW,DING TL,HONG ZX. Clinical analysis of partial hepatectomy combined with radiofrequency ablation in the treatment of primary liver cancer[J]. Traum Crit Med,2018,6(4):226-227,230.(in Chinese)胡雄伟，丁同领，洪智贤．部分肝切除术联合射频消融术治疗原发性肝癌疗效分析[J]．创伤与急危重病医学，2018,6(4):226-227,230.

[26] ZOU H,WU LQ. A propensity score matching analysis of hepatectomy and radiofrequency ablation for patients with solitary hepatocellular carcinoma less than or equal to 5 cm and portal hypertension[J]. Chin J Dig Surg,2018,17(10):1018-1023.(in Chinese)邹浩，吴力群．肝切除术与射频消融术治疗单发肿瘤直径≤5cm肝细胞癌合并门静脉高压症患者的倾向评分匹配疗效分析[J]．中华消化外科杂志，2018,17(10):1018-1023.

[27] IZZO F,GRANATA V,GRASSI R,et al. Radiofrequency ablation and microwave ablation in liver tumors:An update[J].Oncologist,2019,24(10):e990-990e1005.

[28] LIAO M,ZHONG X,ZHANG J,et al. Radiofrequency ablation using a 10-mm target margin for small hepatocellular carcinoma in patients with liver cirrhosis:A prospective randomized trial[J]. J Surg Oncol,2017,115(8):971-979.

[29] HUANG JW,YAN L,CHENG ZY,et al. A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria[J]. Ann Surg,2010,252(6):903-912.

[30] FANG Y,CHEN W,LIANG X,et al. Comparison of longterm effectiveness and complications of radiofrequency ablation with hepatectomy for small hepatocellular carcinoma[J].J Gastroenterol Hepatol,2014,29(1):193-200.

[31] LIANG P,WANG Y. Microwave ablation of hepatocellular carcinoma[J]. Oncology,2007,72(Suppl 1):124-131.

[32] CHONG C,LEE KF,CHEUNG S,et al. Prospective doubleblinded randomized controlled trial of Microwave versus RadioFrequency Ablation for hepatocellular carcinoma(McRFA trial)[J]. HPB(Oxford),2020.(Online ahead of print)

[33] SHI J,SUN Q,WANG Y,et al. Comparison of microwave ablation and surgical resection for treatment of hepatocellular carcinomas conforming to Milan criteria[J]. J Gastroenterol Hepatol,2014,29(7):1500-1507.

[34] FACCIORUSSO A,SERVIDDIO G,MUSCATIELLO N. Local ablative treatments for hepatocellular carcinoma:An updated review[J]. World J Gastrointest Pharmacol Ther,2016,7(4):477-489.

[35] LITTRUP PJ,AOUN HD,ADAM B,et al. Percutaneous cryoablation of hepatic tumors:Long-term experience of a large U. S. series[J]. Abdom Radiol(NY),2016,41(4):767-780.

[36] WANG C,WANG H,YANG W,et al. Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma[J]. Hepatology,2015,61(5):1579-1590.

[37] ZIMMERMAN A,GRAND D,CHARPENTIER KP. Irreversible electroporation of hepatocellular carcinoma:Patient selection and perspectives[J]. J Hepatocell Carcinoma,2017,4:49-58.

[38] NARAYANAN G. Irreversible electroporation[J]. Semin Intervent Radiol,2015,32(4):349-355.

[39] STILLSTRM D,BEERMANN M,ENGSTRAND J,et al. Initial experience with irreversible electroporation of liver tumours[J]. Eur J Radiol Open,2019,6:62-67.

[40] KALRA N,GUPTA P,GORSI U,et al. Irreversible electroporation for unresectable hepatocellular carcinoma:Initial experience[J]. Cardiovasc Intervent Radiol,2019,42(4):584-590.

[41] CHEUNG TT,FAN ST,CHU SK,et al. Survival analysis of highintensity focused ultrasound ablation in patients with smal hepatocellular carcinoma[J]. HPB(Oxford),2013,15:567-73.

[42] LI L,TIAN J,LIU P,et al. Transarterial chemoembolization combination therapy vs monotherapy in unresectable hepatocellular carcinoma:A meta-analysis[J]. Tumori,2016,2016(3):301-310.

[43] CHEUNG TT,FAN ST,CHAN SC,et al. High-intensity focused ultrasound ablation:An effective bridging therapy for hepatocellular carcinoma patients[J]. World J Gastroenterol,2013,19(20):3083-3089.

[44] DI COSTANZO GG,FRANCICA G,PACELLA CM. Laser ablation for small hepatocellular carcinoma:State of the art and future perspectives[J]. World J Hepatol,2014,6(10):704-715.

[45] ORLACCHIO A,BOLACCHI F,CHEGAI F,et al. Comparative evaluation of percutaneous laser and radiofrequency ablation in patients with HCC smaller than 4 cm[J]. Radiol Med,2014,119(5):298-308.

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