Surgical Mainly Comprehensive Treatment Analysis To The 986 Patients With Primary Liver Cancer

Objective:To evaluate the effect of surgical mainly comprehensive therapy for primary liver cancer(PLC).Methods:This study retrospectively analyzed the surgical outcome of hepatocellular carcinoma in patients who underwent hepatic resection at the department of oncological surgery affiliated hospital of Guangxi medical university from April 1985 to December 2006 and follow-up was conducted by telephone and letter connections of the petition.The factors were assessed by spss 13.0 sofeware.Kaplan-Meier method was used to evaluate survival rates and median survival period and assessed various comprehensive therapy of hepatectomy,TACE,inter tumor injection of ethanol(PEI), biotherapy and evaluate effects of survival rate and recurrence rates of surgical predominant comprehensive therapy for the patients with PLC.Result:1.986 patients,among 74 patients to be undergone aparotomy and biopsy,113 with hepatic artery ligation and anticancer agents by hepatic artery infusion,781 Hepatectomy.Among the 781 patients,the longest follow up time 264 months,the shortest time 1 month,8 to loss,387 to die,386 to live now.46 patients live over 10 years,among 25 with no tumor,5 with tumor,16 patients have died.144 patients live over 5 years,among 67 with disease free survival,22 with tumor or other disease,55 patients have died.2.The 1,3,5,10 years survival rates,palliative and radical resectal groupwere70.3%,36.6%,28.1%,17.0%and84.2%,58.5 %,49.0%,32.2%Respectively(P＜0.05).3.The 1,3,5,10 years comprehensive therapy and uncomprehensive therapy resected group were 83.0%,56.0%,46.9%,30.1%and 76.0 %,47.0%,40.1%,24.0%Respectively(P＜0.05).4.The 1,3,5,10years survival rates of different diameters resected liver cancer were(φcancer diameter)φ≤3 cm:94.0%, 77.1%,71.5%,49.5%,3cm＜φ≤5cm:88.4%,61.0%,50.5%,32.9 %,5 cm<φ≤10cm:81.1%,53.4%,43.1%,27.2%,φ＞10cm:66.4 %,30.7%,24.4%,11.0%.Different groups compared,respectively (P＜0.05)。5.The 1,3,5years recurrence rates of different diameters resected liver cancer were(φcancer diameter)φ≤3 cm:10.3%, 25.6%,28.2%,3cm＜φ≤5cm:27.6%,51.9%,57.5%,5 cm＜φ≤10cm: 39.1%,57.3%,63.1%,φ＞1Ocm:57.9%,74.2%,78.6%.Conclusion:1.The direction to cure PLC is surgery predominant comprehensive therapy.2.Esairesis lead to cure the liver cancer,to utilize modern equipment and modern technique to diagnose and treat,to census or early discover small PLC,through combined therapy become the unresectable PLC into the respectable PLC,to improve operating technique and so on to raise exairesis rate.3.Biotherapy and the traditional Chinese medicine to cure, prevent or lower recurrent rate of PLC and raise therapeutic effect of operation to the liver cancer.4.By various combinations of hepatic artery ligation and anticancer agents by hepatic artery infusion(HAL),microwave coagulation,ethanol injection into tumor,cryosurgery,radio frequency(RF)and hepatic artery chemoembolization therapy to cure the unresectable PLC,to raise the total therapeutic effect and send the surgical treatment into a new step,which have extremely important significance to improve the quality of life and extend life with PLC.