Orvosi Hetilap
Volume/Issue:
Volume 151: Issue 37
Surgical oncology of hepatocellular carcinoma (HCC)
Author: Péter Kupcsulik 1
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  • 1 Semmelweis Egyetem, Általános Orvostudományi Kar I. Sebészeti Klinika Budapest Üllői út 78. 1082
DOI:
https://doi.org/10.1556/oh.2010.28905
Page Count:
1483–1487
Publication Date:
01 Sep 2010
Online Publication Date:
31 Aug 2010
Article Category:
Research Article
Open access

A hepatocellularis carcinoma (HCC) gyakorisága világszerte növekszik. Hazánkban évente körülbelül 600 új esettel lehetne számolni, de a rendelkezésre álló adatok szerint ennél sokkal kevesebb jut a hepatológiai gondozás rendszerébe. A sorafenib megjelenése és az ablatív kezelések terjedése mellett a legjobb eredmények a sebészi módszerektől várhatók. Az orthotopicus májátültetés (OTLX) szelektált korai HCC-esetekben igen bíztató eredményeket ígér ugyan, de a hazai transzplantációs kapacitás és az észlelt HCC-esetek stádiuma kizárja, hogy az OTLX legyen az egyedüli megoldás. A sebészi reszekciót a funkcionális májtérfogat határozza meg. A ballebeny-reszekciót a betegek többnyire jól tűrik. A jobb lebeny tumorai a portafőtörzs okklúziója után – megfelelő bal oldali regeneráció esetén – cirrhoticus májban is reszekálhatók. Az intraoperatív prekondicionálás jelentősen csökkenteni képes az ischaemiás-reperfúziós károsodást jelző faktorok szérumszintjét és a műtéti kockázatot. A Semmelweis Egyetem I. Sebészeti Klinikáján 1996–2009 között operált 2167 májtumor között 254 HCC fordult elő. Kétszáztizenegy esetben történt radikális műtét, ez 82,7%-os reszekciós rátának felel meg. Világszerte elterjedőben van a laparoszkópos májreszekció, amely kisebb műtéti megterhelést jelent, mint a nyitott műtét, ezért cirrhoticus máj esetében a javallat fokozottan érvényes. Orv. Hetil., 2010, 37, 1483–1487.

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  • Abdalla, E. K., Denys, A., Hasegawa, K. és mtsai: Treatment of large and advanced hepatocellular carcinoma. Ann. Surg. Oncology, 2008, 15 , 979–985.

    Hasegawa K. , 'Treatment of large and advanced hepatocellular carcinoma ' (2008 ) 15 Ann. Surg. Oncology : 979 -985.

    • Search Google Scholar

  • Abou-Alfa, G. K., Schwartz, L., Ricci, S. és mtsai: Phase II study of sorafenib in patients with advanced hepatocellular carcinoma. J. Clin. Oncol., 2006, 24 , 4293–4300.

    Ricci S. , 'Phase II study of sorafenib in patients with advanced hepatocellular carcinoma ' (2006 ) 24 J. Clin. Oncol. : 4293 -4300.

    • Search Google Scholar

  • Llovet, J., Ricci, S., Mazzaferro, V. és mtsai: Sorafenib improves survival in advanced hepatocellular carcinoma (HCC): Results of a Phase III randomized placebo-controlled trial (SHARP trial). J. Clin. Oncol., 2007, 25 (Suppl.) , LBA1.

    Mazzaferro V. , 'Sorafenib improves survival in advanced hepatocellular carcinoma (HCC): Results of a Phase III randomized placebo-controlled trial (SHARP trial) ' (2007 ) 25 J. Clin. Oncol. : LBA1 -.

    • Search Google Scholar

  • Lau, W-Y., Lai, E. C. H.: Hepatocellular carcinoma: current management and recent advances. Hepatobiliary Pancreat Dis. Int., 2008, 7 , 237–257.

    Lai E. C. H. , 'Hepatocellular carcinoma: current management and recent advances ' (2008 ) 7 Hepatobiliary Pancreat Dis. Int. : 237 -257.

    • Search Google Scholar

  • Zhou, W-P., Lai, E. C. H., Li, A-J. és mtsai: A prospective, randomized, controlled trial of preoperative transarterial chemoembolization for resectable large hepatocellular carcinoma. Ann. Surg., 2009, 249 , 195–202.

    Li A-J. , 'A prospective, randomized, controlled trial of preoperative transarterial chemoembolization for resectable large hepatocellular carcinoma ' (2009 ) 249 Ann. Surg. : 195 -202.

    • Search Google Scholar

  • Garrean, S.: Radiofrequency ablation of primary and metastatic liver tumors: a critical review of the literature. Amer. J. Surg., 2008, 195 , 508–520.

    Garrean S. , 'Radiofrequency ablation of primary and metastatic liver tumors: a critical review of the literature ' (2008 ) 195 Amer. J. Surg. : 508 -520.

    • Search Google Scholar

  • Hasegawa, K., Kokudo, N., Makuuchi, M.: Surgery or ablation for hepatocellular carcinoma? Ann. Surg., 2008, 247 , 557–558.

    Makuuchi M. , 'Surgery or ablation for hepatocellular carcinoma? ' (2008 ) 247 Ann. Surg. : 557 -558.

    • Search Google Scholar

  • Lencioni, R., Crocetti, L.: Image-guided thermal ablation of hepatocellular carcinoma. Crit. Rev. Oncol./Hematol., 2008, 66 , 200–207.

    Crocetti L. , 'Image-guided thermal ablation of hepatocellular carcinoma ' (2008 ) 66 Crit. Rev. Oncol./Hematol. : 200 -207.

    • Search Google Scholar

  • Schwarz, R. E., Smith, D. D.: Trends in local therapy for hepatocellular carcinoma and survival outcomes in the US population. Amer. J. Surgery, 2008, 195 , 829–836.

    Smith D. D. , 'Trends in local therapy for hepatocellular carcinoma and survival outcomes in the US population ' (2008 ) 195 Amer. J. Surgery : 829 -836.

    • Search Google Scholar

  • Whitney, R., Tatum, C., Hahl, M. és mtsai: Safety of hepatic resection in metastatic disease to the liver after yttrium-90 therapy. J. Surg. Res., 2009, DOI:10.1016/j.jss.2009.05.021

    Hahl M. , 'Safety of hepatic resection in metastatic disease to the liver after yttrium-90 therapy ' (2009 ) J. Surg. Res. : -.

    • Search Google Scholar

  • Zimmerman, M. A., Ghobrial, R. M., Tong, M. J. és mtsai: Recurrence of hepatocellular carcinoma following liver transplantation. A review of preoperative and postoperative prognostic indicators. Arch. Surg., 2008, 143 , 182–188.

    Tong M. J. , 'Recurrence of hepatocellular carcinoma following liver transplantation. A review of preoperative and postoperative prognostic indicators ' (2008 ) 143 Arch. Surg. : 182 -188.

    • Search Google Scholar

  • Facciuto, M. E., Koneru, B., Rocca, J. P. és mtsai: Surgical treatment of hepatocellular carcinoma beyond Milan criteria. Results of liver resection, salvage transplantation, and primary liver transplantation. Ann. Surg. Oncol., 2008, 15 , 1383–1391.

    Rocca J. P. , 'Surgical treatment of hepatocellular carcinoma beyond Milan criteria. Results of liver resection, salvage transplantation, and primary liver transplantation ' (2008 ) 15 Ann. Surg. Oncol. : 1383 -1391.

    • Search Google Scholar

  • Cucchetti, A., Ercolani, G., Vivarelli, M. és mtsai: Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis. Liver Transpl., 2006, 12 , 966–971.

    Vivarelli M. , 'Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis ' (2006 ) 12 Liver Transpl. : 966 -971.

    • Search Google Scholar

  • Cescon, M., Cucchetti, A., Grazi, G. L. és mtsai: Indication of the extent of hepatectomy for hepatocellular carcinoma on cirrhosis by a simple algorithm based on preoperative variables. Arch. Surg., 2009, 144 , 57–63.

    Grazi G. L. , 'Indication of the extent of hepatectomy for hepatocellular carcinoma on cirrhosis by a simple algorithm based on preoperative variables ' (2009 ) 144 Arch. Surg. : 57 -63.

    • Search Google Scholar

  • Pawlik, T. M., Poon, R. T., Abdalla, E. K. és mtsai: Critical appraisal of the clinical and pathologic predictors of survival after resection of large hepatocellular carcinoma. Arch. Surg., 2005, 140 , 450–457.

    Abdalla E. K. , 'Critical appraisal of the clinical and pathologic predictors of survival after resection of large hepatocellular carcinoma ' (2005 ) 140 Arch. Surg. : 450 -457.

    • Search Google Scholar

  • Paugam-Burtz, C., Janny, S., Delefosse, D. és mtsai: Prospective validation of the “fifty-fifty” criteria as an early and accurate predictor of death after liver resection in intensive care unit patients. Ann. Surg., 2009, 249 , 124–128.

    Delefosse D. , 'Prospective validation of the “fifty-fifty” criteria as an early and accurate predictor of death after liver resection in intensive care unit patients ' (2009 ) 249 Ann. Surg. : 124 -128.

    • Search Google Scholar

  • Abulkhir, A. és mtsai: Preoperative portal vein embolization for major liver resection. A meta-analysis. Ann. Surg., 2008, 247 , 49–57.

    Abulkhir A. , 'Preoperative portal vein embolization for major liver resection. A meta-analysis ' (2008 ) 247 Ann. Surg. : 49 -57.

    • Search Google Scholar

  • Hwang, S., Lee, S-G., Ko, G-Y. és mtsai: Sequential preoperative ipsilateral hepatic vein embolization after portal vein embolization to induce further liver regeneration in patients with hepatobiliary malignancy. Ann. Surg., 2009, 249 , 608–616.

    Ko G-Y. , 'Sequential preoperative ipsilateral hepatic vein embolization after portal vein embolization to induce further liver regeneration in patients with hepatobiliary malignancy ' (2009 ) 249 Ann. Surg. : 608 -616.

    • Search Google Scholar

  • Ribero, D.: Selection for resection of hepatocellular carcinoma and surgical strategy: indications for resection, evaluation of liver function, portal vein embolization, and resection. Ann. Surg. Oncology, 2008, 15 , 986–992.

    Ribero D. , 'Selection for resection of hepatocellular carcinoma and surgical strategy: indications for resection, evaluation of liver function, portal vein embolization, and resection ' (2008 ) 15 Ann. Surg. Oncology : 986 -992.

    • Search Google Scholar

  • Yang, L-Y., Fang, F., Ou, D-P. és mtsai: Solitary large hepatocellular carcinoma. A specific subtype of hepatocellular carcinoma with good outcome after hepatic resection. Ann. Surg., 2009, 249 , 118–123.

    Ou D-P. , 'Solitary large hepatocellular carcinoma. A specific subtype of hepatocellular carcinoma with good outcome after hepatic resection ' (2009 ) 249 Ann. Surg. : 118 -123.

    • Search Google Scholar

  • Nguyen, K. T., Gamblin, T. C., Geller, D. A.: World review of laparoscopic liver resection – 2,804 patients. Ann. Surg., 2009, 250 , 831–841.

    Geller D. A. , 'World review of laparoscopic liver resection – 2,804 patients ' (2009 ) 250 Ann. Surg. : 831 -841.

    • Search Google Scholar

  • Cai, X. J., Yang, J., Yu, H. és mtsai: Clinical study of laparoscopic versus open hepatectomy for malignant liver tumors. Surg. Endosc., 2008, 22 , 2350–2356.

    Yu H. , 'Clinical study of laparoscopic versus open hepatectomy for malignant liver tumors ' (2008 ) 22 Surg. Endosc. : 2350 -2356.

    • Search Google Scholar

  • Yoon, Y-S., Han, H-S., Cho, J. Y. és mtsai: Total laparoscopic liver resection for hepatocellular carcinoma located in all segments of the liver. Surg. Endosc., 2010, 24 , 1630–1637. (Published online 25 December 2009.)

    Cho J. Y. , 'Total laparoscopic liver resection for hepatocellular carcinoma located in all segments of the liver ' (2010 ) 24 Surg. Endosc. : 1630 -1637.

    • Search Google Scholar

  • Teramoto, K., Kawamura, T., Takamatsu, S. és mtsai: Laparoscopic and thoracoscopic partial hepatectomy for hepatocellular carcinoma. World J. Surg., 2003, 27 , 1131–1136.

    Takamatsu S. , 'Laparoscopic and thoracoscopic partial hepatectomy for hepatocellular carcinoma ' (2003 ) 27 World J. Surg. : 1131 -1136.

    • Search Google Scholar

  • Tranchart, H., Di Giuro, G., Lainas, P. és mtsai: Laparoscopic resection for hepatocellular carcinoma: a matched-pair comparative study. Surg. Endosc., 2010, 24 , 1170–1176. (Epub 2009 Nov 14.)

    Lainas P. , 'Laparoscopic resection for hepatocellular carcinoma: a matched-pair comparative study ' (2010 ) 24 Surg. Endosc. : 1170 -1176.

    • Search Google Scholar

  • Vigano, L., Laurent, A., Tayar, C. és mtsai: The learning curve in laparoscopic liver resection: improved feasibility and reproducibility. Ann. Surg., 2009, 250 , 772–782.

    Tayar C. , 'The learning curve in laparoscopic liver resection: improved feasibility and reproducibility ' (2009 ) 250 Ann. Surg. : 772 -782.

    • Search Google Scholar

  • Buell, J. F., Cherqui, D., Geller, D. A. és mtsai: The International Position on Laparoscopic Liver Surgery. The Louisville Statement, 2008. Ann. Surg., 2009, 250 , 825–830.

    Geller D. A. , 'The International Position on Laparoscopic Liver Surgery. The Louisville Statement, 2008 ' (2009 ) 250 Ann. Surg. : 825 -830.

    • Search Google Scholar

  • Belli, G., Limongelli, P., Fantini, C. és mtsai: Laparoscopic and open treatment of hepatocellular carcinoma in patients with cirrhosis. Br. J. Surg., 2009, 96 , 1041–1048.

    Fantini C. , 'Laparoscopic and open treatment of hepatocellular carcinoma in patients with cirrhosis ' (2009 ) 96 Br. J. Surg. : 1041 -1048.

    • Search Google Scholar

  • Chen, H. Y., Juan, C. C., Ker, C. G.: Laparoscopic liver surgery for patients with hepatocellular carcinoma. Ann. Surg. Oncol., 2008, 15 , 800–806.

    Ker C. G. , 'Laparoscopic liver surgery for patients with hepatocellular carcinoma ' (2008 ) 15 Ann. Surg. Oncol. : 800 -806.

    • Search Google Scholar

  • Cherqui, D., Laurent, A., Tayar, C. és mtsai: Laparoscopic liver resection for peripherial hepatocellular carcinoma in patients with chronic liver disease: midterm results and perspectives. Ann. Surg., 2006, 243 , 499–506.

    Tayar C. , 'Laparoscopic liver resection for peripherial hepatocellular carcinoma in patients with chronic liver disease: midterm results and perspectives ' (2006 ) 243 Ann. Surg. : 499 -506.

    • Search Google Scholar

  • Buell, J. F., Thomas, M. T., Rudich S. és mtsai: Experience with more than 500 minimally invasive hepatic procedures. Annals of Surgery, 2008, 248 , 475–486.

    Rudich S. , 'Experience with more than 500 minimally invasive hepatic procedures ' (2008 ) 248 Annals of Surgery : 475 -486.

    • Search Google Scholar

  • Dagher, I., Lainas, P., Carloni, A. és mtsai: Laparoscopic liver resection for hepatocellular carcinoma. Surg. Endoscopy, 2008, 22 , 372–378.

    Carloni A. , 'Laparoscopic liver resection for hepatocellular carcinoma ' (2008 ) 22 Surg. Endoscopy : 372 -378.

    • Search Google Scholar

  • Inagaki, H., Kurokawa, T., Nonami, T. és mtsai: Hand-assisted laparoscopic left lateral segmentectomy of the liver for hepatocellular carcinoma with cirrhosis. J. Hepatobiliary Pancreat. Surg., 2003, 10 , 295–298.

    Nonami T. , 'Hand-assisted laparoscopic left lateral segmentectomy of the liver for hepatocellular carcinoma with cirrhosis ' (2003 ) 10 J. Hepatobiliary Pancreat. Surg. : 295 -298.

    • Search Google Scholar

  • Lai, E. C. H., Tang, C. N., Yang, G. P. C. és mtsa: Minimally invasive surgical treatment of hepatocellular carcinoma: Long-Term Outcome. World J. Surg., 2009, 33 , 2150–2154.

    Yang G. P. C. , 'Minimally invasive surgical treatment of hepatocellular carcinoma: Long-Term Outcome ' (2009 ) 33 World J. Surg. : 2150 -2154.

    • Search Google Scholar

  • Shimada, M., Hashizume, M., Maehara, S. és mtsai: Laparoscopic hepatectomy for hepatocellular carcinoma. Surg. Endosc., 2001, 15 , 541–544.

    Maehara S. , 'Laparoscopic hepatectomy for hepatocellular carcinoma ' (2001 ) 15 Surg. Endosc. : 541 -544.

    • Search Google Scholar
Cover Orvosi Hetilap
Orvosi Hetilap
Print ISSN:
0030-6002
Online ISSN:
1788-6120
Keywords:
májcirrhosis; HCC; regeneráció; sebészi reszekció; prekondicionálás; liver cirrhosis; hepatocellular carcinoma; liver regeneration; surgical resection; preconditioning

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