• 四川大學華西醫(yī)院普外二科（成都 610041 ）;

【摘要】目的  了解肝癌患者行肝移植或肝切除兩種手術治療后腫瘤復發(fā)的不同特點。方法  復習國內(nèi)、外文獻，比較二者的特點。 結果  肝癌肝移植與肝癌肝切除術后復發(fā)率、復發(fā)時間、常見部位、復發(fā)相關因素、機理等方面均有所不同。結論  根據(jù)肝癌肝移植或肝切除術后復發(fā)的不同特點，針對性地加強肝癌復發(fā)的預防，重視復發(fā)后的治療，以延長術后生存，改善生活質量。

引用本文： 呂波,文天夫. 肝癌肝移植及肝癌肝切除術后復發(fā)特點的比較. 中國普外基礎與臨床雜志, 2008, 15(3): 166-170. doi: 復制

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3. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis [J]. N Engl J Med, 1996； 334(11)∶693.
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39. Guba M,Von Breitenbuch P,Steinbauer M, et al. Rapamycin inhibits primary and metastatic tumor growth by antiangiogenesis: involvement of vascular endothelial growth factor [J]. Nat Med, 2002； 8(2)∶128.
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45. Sderdahl G, Bckman L, Isoniemi H, et al. A prospective,randomized, multi-centre trial of systemic adjuvant chemotherapy versus no additional treatment in liver transplantation for hepatocellular carcinoma [J]. Transpl Int, 2006； 19(4)∶288.
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  1. 1. 68 Poon RT, Fan ST, Lo CM, et al. Long-term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation [ J ] . Ann Surg, 2002; 235(3) ∶ 373.
  2. 2. Jemal A, Murray T, Ward E, et al. Cancer statistics， 2005 [J]. CA Cancer J Clin, 2005； 55（1）∶10.
  3. 3. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis [J]. N Engl J Med, 1996； 334(11)∶693.
  4. 4. Marsh JW, Dvorchik I, Bonham CA, et al. Is the pathologic TNM staging system for patients with hepatoma predictive of outcome? [J]. Cancer， 2000; 88(3)∶538.
  5. 5. Yao FY, Ferrell L, Bass NM, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival [J]. Hepatology, 2001; 33(6)∶1394.
  6. 6. 嚴律南， 王震俠. 肝癌肝移植的適應證及應用前景 [J]. 中國普外基礎與臨床雜志， 2006; 13（2）∶132.
  7. 7. 樊嘉, 周儉, 徐泱, 等. 肝癌肝移植適應證的選擇: 上海復旦標準 [J]. 中華醫(yī)學雜志, 2006; 86(18)∶1227.
  8. 8. 吳階平， 裘法祖主編. 黃家駟外科學（上、中、下） [M]. 第6版. 北京: 人民衛(wèi)生出版社, 2000∶1230~1233.
  9. 9. Sun HC, Tang ZY. Preventive treatment for recurrence after curative resection of hepatocellular carcinoma——a literature review of randomized control trial [J]. World J Gasrtoenterol, 2003; 9(4)∶635.
  10. 10. 黃潔夫主編. 肝臟膽道腫瘤外科學 [M]. 北京: 人民衛(wèi)生出版社, 1999∶673~677.
  11. 11. 湯釗猷, 余業(yè)勤主編. 原發(fā)性肝癌(2) [M]. 上海: 上?？茖W技術出版社, 1998∶438~440.
  12. 12. Regalia E, Fassati LR, Valente U, et al. Pattern and management of recurrent hepatocellular carcinoma after liver transplantation [J]. J Hepatobiliary Pancreat Surg, 1998； 5(1)∶29.
  13. 13. Roayaie S, Schwartz JD, Sung MW, et al. Recurrence of hepatocellular carcinoma after liver transplant: patterns and prognosis [J]. Liver Transpl, 2004; 10(4)∶534.
  14. 14. 吳天鳴, 楊翔, 賀強, 等. 肝移植治療原發(fā)性肝癌的探討 [J]. 臨床外科雜志, 2002; 10（6）∶371.
  15. 15. 鄭樹森, 吳健, 黃東勝, 等. 肝臟移植在治療肝臟惡性腫瘤中的作用 [J]. 中華肝膽外科雜志, 2002; 8（5）∶265.
  16. 16. Kumada T, Nakano S, Takeda I, et al. Patterns of recurrence after initial treatment in patients with small hepatocellular carcinoma [J]. Hepatology, 1997; 25(1)∶87.
  17. 17. Schlitt HJ, Neipp M, Weimann A, et al. Recurrence patterns of hepatocellular and fibrolamellar carcinoma after liver transplantation [J]. J Clin Oncol, 1999; 17(1)∶324.
  18. 18. Kakumu S. Trends in liver cancer researched by the Liver Cancer Study Group of Japan [J]. Hepatol Res, 2002; 24(Suppl)∶21.
  19. 19. Ikai I, Itai Y, Okita K, et al. Report of the 15th follow-up survey of primary liver cancer [J]. Hepatol Res, 2004; 28(1)∶21.
  20. 20. 林芷英, 湯釗猷, 余業(yè)勤, 等. 原發(fā)性肝癌根治切除后的復發(fā)和治療 [J]. 中華外科雜志, 1991; 29（2）∶93.
  21. 21. 楊世忠, 董家鴻. 肝癌肝外轉移復發(fā)的臨床研究進展 [J]. 中華普通外科雜志, 2004; 19（1）∶56.
  22. 22. Katyal S, Oliver JH 3rd, Peterson MS, et al. Extrahepatic metastases of hepatocellular carcinoma [J]. Radiology, 2000; 216(3)∶698.
  23. 23. Hemming AW, Cattral MS, Reed AI, et al. Liver transplantation for hepatocellular carcinoma [J]. Ann Surg, 2001; 233(5)∶652.
  24. 24. Salizzoni M, Romagnoli R, Lupo F, et al. Microscopic vascular invasion detected by anti-CD34 immunohistochemistry as a predictor of recurrence of hepatocellular carcinoma after liver transplantation [J]. Transplantation, 2003; 76(5)∶844.
  25. 25. Shah SA, Tan JC, McGilvray ID, et al. Accuracy of staging as a predictor for recurrence after liver transplantation for hepatocellular carcinoma [J]. Transplantation, 2006; 81(12)∶1633.
  26. 26. Bismuth H, Majno PE, Adam R. Liver transplantation for hepatocellular carcinoma [J]. Semin Liver Dis, 1999; 19(3)∶311.
  27. 27. Roayaie S, Frischer JS, Emre SH, et al. Long-term results with multimodal adjuvant therapy and liver transplantation for the treatment of hepatocellular carcinomas larger than 5 centimeters [J]. Ann Surg, 2002; 235(4)∶533.
  28. 28. Jonas S, Bechstein WO, Steinmüller T, et al. Vascular invasion and histopathologic grading determine outcome after liver transplantation for hepatocellular carcinoma in cirrhosis [J]. Hepatology, 2001; 33(5)∶1080.
  29. 29. Grasso A, Stigliano R, Morisco F, et al. Liver transplantation and recurrent hepatocellular carcinoma: predictive value of nodule size in a retrospective and explant study [J]. Transplantation, 2006; 81(11)∶1532.
  30. 30. Pawlik TM, Delman KA, Vauthey JN, et al. Tumor size predicts vascular invasion and histologic grade: Implications for selection of surgical treatment for hepatocellular carcinoma [J]. Liver Transpl, 2005; 11(9)∶1086.
  31. 31. Plessier A, Codes L, Consigny Y, et al. Underestimation of the influence of satellite nodules as a risk factor for post-transplantation recurrence in patients with small hepatocellular carcinoma [J]. Liver Transpl, 2004; 10(2 Suppl 1)∶S86.
  32. 32. Esnaola NF,Lauwers GY,Mirza NQ, et al. Predictors of microvascular invasion in patients with hepatocellular carcinoma who are candidates for orthotopic liver transplantation [J]. J Gastrointest Surg, 2002； 6(2)∶224.
  33. 33. Vivarelli M, Bellusci R, Cucchetti A, et al. Low recurrence rate of hepatocellular carcinoma after liver transplantation: better patient selection or lower immunosuppression? [J]. Transplantation， 2002; 74(12)∶1746.
  34. 34. Herrero JI, Sangro B, Quiroga J, et al. Influence of tumor characteristics on the outcome of liver transplantation among patients with liver cirrhosis and hepatocellular carcinoma [J]. Liver Transpl, 2001; 7(7)∶631.
  35. 35. 黃潔夫. 肝移植治療原發(fā)性肝癌的現(xiàn)狀及前景 [J]. 肝膽外科雜志, 1999； 7（3）∶163.
  36. 36. Vivarelli M, Cucchetti A, Piscaglia F, et al. Analysis of risk factors for tumor recurrence after liver transplantation for hepatocellular carcinoma: key role of immunosuppression [J]. Liver Transpl, 2005; 11(5)∶497.
  37. 37. Majno P, Giostra E, Mentha G; Geneva Liver Cancer Study. Is there a customised immunosuppressive regimen for patients transplanted with hepatocellular carcinoma? [J]. J Hepatol, 2005; 43(4)∶577.
  38. 38. 楊甲梅, 溫增慶. 肝移植術治療原發(fā)性肝癌 [J]. 肝膽外科雜志,1999； 7（3）∶166.
  39. 39. Guba M,Von Breitenbuch P,Steinbauer M, et al. Rapamycin inhibits primary and metastatic tumor growth by antiangiogenesis: involvement of vascular endothelial growth factor [J]. Nat Med, 2002； 8(2)∶128.
  40. 40. Luan FL, Hojo M, Maluccio M, et al. Rapamycin blocks tumor progression: unlinking immunosuppression from antitumor efficacy [J]. Transplantation, 2002; 73(10)∶1565.
  41. 41. 王征, 樊嘉, 周儉, 等. 雷帕霉素抑制肝癌細胞生長及轉移的實驗研究 [J]. 中華醫(yī)學雜志， 2006; 86(24)∶1666.
  42. 42. Mazzaferro V, Battiston C, Perrone S, et al. Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation: a prospective study [J]. Ann Surg, 2004; 240(5)∶900.
  43. 43. Fontana RJ, Hamidullah H, Nghiem H, et al. Percutaneous radiofrequency thermal ablation of hepatocellular carcinoma: a safe and effective bridge to liver transplantation [J]. Liver Transpl, 2002; 8(12)∶1165.
  44. 44. Ghobrial RM, Shimoda M, Farmer DG, et al. Factors determining outcome of liver transplantation for hepatocellular carcinoma associated with hepatitis C cirrhosis [J]. Transplant Proc, 2001; 33(1-2)∶1358.
  45. 45. Sderdahl G, Bckman L, Isoniemi H, et al. A prospective,randomized, multi-centre trial of systemic adjuvant chemotherapy versus no additional treatment in liver transplantation for hepatocellular carcinoma [J]. Transpl Int, 2006； 19(4)∶288.
  46. 46. Adam R, Azoulay D, Castaing D, et al. Liver resection as a bridge to transplantation for hepatocellular carcinoma on cirrhosis: a reasonable strategy? [J]. Ann Surg, 2003; 238(4)∶508.
  47. 47. Belghiti J, Cortes A, Abdalla EK, et al. Resection prior to liver transplantation for hepatocellular carcinoma [J]. Ann Surg, 2003; 238(6)∶885.
  48. 48. Knechtle SJ. Challenging choices: liver transplantation for hepatocellular carcinoma [J]. Ann Surg, 2004; 239(2)∶160.
  49. 49. Regimbeau JM, Abdalla EK, Vauthey JN, et al. Risk factors for early death due to recurrence after liver resection for hepatocellular carcinoma: results of a multicenter study [J]. J Surg Oncol, 2004; 85(1)∶36.
  50. 50. Poon RT, Fan ST, Ng IO, et al. Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma [J]. Cancer, 2000; 89(3)∶500.
  51. 51. 季錫清, 李朝龍, 楊進城, 等. 影響原發(fā)性肝細胞肝癌切除術預后的多因素分析 [J]. 中國普通外科雜志, 2004； 19(2)∶91.
  52. 52. Jwo SC, Chiu JH, Chau GY, et al. Risk factors linked to tumor recurrence of human hepatocellular carcinoma after hepatic resection [J]. Hepatology, 1992; 16(6)∶1367.
  53. 53. Huang YH, Wu JC, Chen CH, et al. Comparison of recurrence after hepatic resection in patients with hepatitis B vs. hepatitis C-related small hepatocellular carcinoma in hepatitis B virus endemic area [J]. Liver Int, 2005; 25(2)∶236.
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