[Hepatic resections for primary and secondary malignant pathology of the liver: our experience].

P Soliani, A Galimberti, P Dell'Abate, E Foggi
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Abstract

The aim of this work is to describe the three years experience in hepatic resections for primitive and metastatic liver tumors. Of the 90 patients considered initially only 33% was admitted to radical surgical treatment, after a complete clinical and instrumental evaluation. Twenty of them was affected by liver metastases, most of which from colo-rectal cancer; ten had hepatocellular carcinoma developed on hepatic cirrhosis. All the patients affected by HCC underwent pre-operative chemoembolisation (TACE). Regional chemotherapy (TACI) was performed in synchronous metastatic tumors before surgical treatment. Surgical resection in HCC was extremely limited, removing at most 35% of total liver volume. For metastatic tumors 12 major resections and 8 minor resections was carried out. Postoperative complications occurred in 13.3%, including one death for digestive bleeding. A relationship between intraoperative risk factors, such as blood loss and transfusions was registered. The actuarial surviving rate was 47.5% for HCC and 48.3% for colo-rectal metastases at three years. Finally, preoperative CEA levels was the only factor significantly related to long term prognosis of patients affected by liver colo-rectal metastases.

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[原发性和继发性肝脏恶性病变的肝脏切除术:我们的经验]。
这项工作的目的是描述三年的经验在肝脏切除原始和转移性肝肿瘤。在最初考虑的90例患者中,经过完整的临床和仪器评估后,只有33%的患者接受根治性手术治疗。其中20例发生肝转移,多数来自结直肠癌;10例在肝硬化后发展为肝细胞癌。所有HCC患者均行术前化疗栓塞(TACE)。同步转移性肿瘤术前均行局部化疗(TACI)。肝细胞癌的手术切除极为有限,最多切除肝总体积的35%。转移性肿瘤行大切除12例,小切除8例。术后并发症发生率为13.3%,其中1例因消化道出血死亡。术中危险因素,如失血和输血之间的关系被记录下来。肝癌的3年精算生存率为47.5%,结肠直肠转移的3年精算生存率为48.3%。最后,术前CEA水平是影响肝结直肠转移患者长期预后的唯一因素。
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