肝癌肝移植术后骨转移患者的手术治疗

李照,高杰,孙馨等.肝癌肝移植术后骨转移患者的手术治疗李照[J].中华普通外科杂志.2013.28（3）：193-195

癌,肝细胞; 肝移植; 骨转移

李照,高杰,孙馨,栗光明,朱继业

10O44 北京大学人民医院肝胆外科 北京大学器官移 植中心

0

193-195

知网,2

​ 目的 分析肝癌肝移植术后肝癌骨转移患者的临床特征、 手术疗效及预后影响因素。方法 回顾性分析2000年 7月 至2010年 1月 就诊于北京大学人民医院20例肝癌肝移植术后骨转移手术患者的临床资料,总结其临床特征,随访了患 者的生存状况。与同时期未行手术治疗的患者进行对比,评价手术疗效,对可能影响患者的预后因素进行单、 多因素分析。 结果 肝移植术后肝癌骨转移患者的中位牛存时间为75个月,肝癌骨转移术后 1年生存率仅为20%.手术治疗能够明显改善患者的疼痛和一般体力状况。单囚素发现肝癌骨转移时的终末期肝病模型(model end-stage liver disease,MELD)评 分和肝癌是否伴有微血管浸润是影响患者预后的因素。多因素分析提示，手术切除肝癌是否伴有微血管浸润是影响患者预后的危险因素。 结论 肝移植术后肝癌骨转移的患者预后较差,手术治疗能够提高这类患者的牛活质量。肝移植时肝癌是否合并微血管浸润影响这些手术患者预后的独立危险因素。 Obective To analyze clinical features, surgical treatment efficacy and prognostic factors of bone metastasis patients after liver transplantation for hepatocellular carcinoma Methods A retrospective clinica1 data of 20 bone metastasis patients after liver transplantation for hepatocellular carcinoma丘 om July2000to January2010were received The effect of surge,aimed at bone metastasis Was evaluated Univariate and mu1tivariatc prognostic risk factors were analyzed . Results The median survival time of these patients was 7.5 months and 1-year suviva1 rate was only 20% Surgical treatment could re1ieve pain and promote patients′peformance status signiflcant1y. Univariate and multivariate analysis found that tumor microvascular invasion within the removed recipient liver was the only prognostic risk factor Conc1usions Patients of bone metastasis after liver transp1antation for HCC had poor prognosis Surgical treatment helps improve patient′ s qua1ity of life Tumor microvascular invasion is the risk factor of surgica1 prognosis.