Scherber P R, Gäbelein G, Eisele R M, Igna D, Glanemann M
Klinik für Allgemeine Chirurgie, Viszeral‑, Gefäß- und Kinderchirurgie, Universitätsklinikum des Saarlandes, Kirrbergerstraße 1, 66421, Homburg/Saar, Deutschland.
Chirurg. 2018 Apr;89(4):281-288. doi: 10.1007/s00104-017-0538-5.
Hepatocellular carcinoma (HCC) ranks among the most common primary cancers of the liver. The major risk factor for the formation of HCC is liver cirrhosis. The grade of cirrhosis as well as the extent of the tumor itself, can play an important role in the treatment options and patient prognosis. An operation aimed at an R0 resection is the treatment of choice for patients in an early stage of the disease and is associated with favorable long-term and recurrence-free survival. Liver transplantation offers an even better long-term survival rate after 5 years for selected patients with HCC meeting the Milan criteria as the underlying cirrhosis, the major risk factor for HCC recurrence, is simultaneously treated. Local tumor ablation is the least invasive curative surgical treatment, however, it is associated with an increased local recurrence rate; therefore, the early detection of tumors is of essential importance. As tumor-associated symptoms tend to arise only in advanced tumor stages, it is indispensable to identify patients with typical risk factors and to provide closely monitored screening examinations.
肝细胞癌(HCC)是最常见的原发性肝癌之一。HCC形成的主要危险因素是肝硬化。肝硬化的程度以及肿瘤本身的范围,在治疗方案和患者预后方面都可能发挥重要作用。旨在实现R0切除的手术是疾病早期患者的首选治疗方法,且与良好的长期生存及无复发生存相关。对于符合米兰标准的部分HCC患者,肝移植可带来更好的5年长期生存率,因为作为HCC复发主要危险因素的潜在肝硬化同时得到了治疗。局部肿瘤消融是侵入性最小的根治性手术治疗,但它与局部复发率增加相关;因此,肿瘤的早期检测至关重要。由于肿瘤相关症状往往仅在肿瘤晚期出现,识别具有典型危险因素的患者并提供密切监测的筛查检查是必不可少的。