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【科普】肝癌在肝移植前的治疗
Author:Belghiti J, Carr BI, Greig PD, Lencioni R, Poon RT.
source: Ann Surg Oncol. 2008 Apr;15(4):993-1000.
IF:3.225(2006)
Liver transplantation (LT) which is currently an established therapy for sma1l, early stage hepatocellular carcinoma (HCC) in patients with cirrhosis requires in most cases long waiting period. Tumor development during the waiting period may be associated with vascular invasion which is a strong factor of postoperative recurrence. Therefore, local treatment of the tumor including trans-arterial chemoembolization (TACE), percutaneous radiofrequency (RF) or partial liver resection can be used before transplantation. In the present paper we reviewed the efficacy of these treatments prior to LT. Although, TACE induced complete tumor necrosis in some patients there is no convincing arguments showing that this treatment reduces the rate of drop out before LT, nor improves the survival after LT. Although, RF can induce complete necrosis in the majority of small tumors (<2.5 cm), there is no data demonstrating that this treatment reduce the rate of drop out before LT, nor improves the survival after LT. It has been showed that both short and long term survival after LT was not compromised by previous partial liver resection of HCC. However, there is no data demonstrating that liver resection before LT, which can be used either as a bridge treatment or as a primary treatment, improves the survival after LT. The current data suggest that there is no role for pre-transplant therapy for HCC within Milano criteria transplanted within six months. On the opposite, if the waiting time is predicted to be prolonged, the risk of tumor progression and either drop-off from the list or interval dissemination with post-transplant tumor recurrence is recognized. In this setting, bridge therapy can reduce that risk but its efficacy has to be determined. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 Title:Treatment before liver transplantation for HCC.
移植前肝癌的治疗
Author:Belghiti J, Carr BI, Greig PD, Lencioni R, Poon RT.
source: Ann Surg Oncol. 2008 Apr;15(4):993-1000.
Liver transplantation (LT) which is currently an established therapy for sma1l, early stage hepatocellular carcinoma (HCC) in patients with cirrhosis requires in most cases long waiting period.
肝移植是目前治疗合并有肝硬化早期小肝癌的有效手段，然而绝大多数患者需要长期等待肝源。
Tumor development during the waiting period may be associated with vascular invasion which is a strong factor of postoperative recurrence.
在等待过程中，由于出现血管侵犯，导致肿瘤发展，这也是术后复发的一个重要因素。
Therefore, local treatment of the tumor including trans-arterial chemoembolization (TACE), percutaneous radiofrequency (RF) or partial liver resection can be used before transplantation.
因此，在移植前需要一些局部的治疗，包括经动脉化疗栓塞、经皮射频消融及肝部分切除。
In the present paper we reviewed the efficacy of these treatments prior to LT.
在此，我们将对这些移植前的局部治疗的疗效作一综述。
Although, TACE induced complete tumor necrosis in some patients there is no convincing arguments showing that this treatment reduces the rate of drop out before LT, nor improves the survival after LT. Although, RF can induce complete necrosis in the majority of small tumors (<2.5 cm), there is no data demonstrating that this treatment reduce the rate of drop out before LT, nor improves the survival after LT.
尽管一些患者经动脉化疗栓塞治疗后，可以使整个肿瘤坏死；经皮射频消融可以使绝大多数直径<2.5 cm的小肿瘤完全坏死，但是没有可信的证据显示动脉化疗栓塞和经皮射频消融可以减少肝移植前的中途退出率以及改善移植后的存活率。
It has been showed that both short and long term survival after LT was not compromised by previous partial liver resection of HCC.
一些研究也证实了进行肝癌部分肝切除不能改善肝癌患者短期和长期的存活率。
However, there is no data demonstrating that liver resection before LT, which can be used either as a bridge treatment or as a primary treatment, improves the survival after LT.
但是，目前还没有数据显示，作为一个过度或者初步的治疗，肝移植前进行肝切除是否可以改善移植后的存活率。
The current data suggest that there is no role for pre-transplant therapy for HCC within Milano criteria transplanted within six months.
目前也没根据米拉诺标准对肝癌移植前治疗对移植后六个月内的影响进行评估。
On the opposite, if the waiting time is predicted to be prolonged, the risk of tumor progression and either drop-off from the list or interval dissemination with post-transplant tumor recurrence is recognized.
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作者:admin@医学,生命科学 2011-03-30 15:14
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