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本帖最后由 linx 于 2014-10-20 03:12 编辑
回复 hy49 的帖子
我就再翻出我的老帖,希望可以有人看看。
ttp://www.hbvhbv.info/forum/thread-1138283-1-1.html
老帖里面我只翻译了移植标准那部分,现在看来有必要拷贝出诊断肝癌后治疗的选择部分:
Treatment of HCC
The only proven potentially curative therapy for HCC remains surgical, either
hepatic resection or liver transplantation and patients should always have these
modalities of treatment considered.
HCC 都要考虑外科手术切除的可能,或者切除,或者移植。在这里英国并不把射频认为和手术一样可以根治。
• Patients with suspected HCC should be diagnosed and assessed for
treatment within the 62-day target 这个是英国对NHS的要求,对可疑肝癌2个月内必须确诊和确定治疗方式,这个太惨了,会等出人命的。
• Liver transplantation should be considered in any patient with cirrhosis and a
small lesion (5cm or less single nodule, or up to five lesions of 3cm or less) or
in patients with a single lesion greater than 5cm and less than or equal to 7cm
diameter where there has been no evidence of tumour progression (volume
increase by <20%; no extrahepatic spread; no new nodule formation) over a 6
month period. Locoregional therapy +/- chemotherapy may be given during
that time. Locoregional therapy should be considered for all transplant list
cases (evidence grade IIa, recommendation grade B).
任何肝癌伴随硬化的病人应该考虑移植。后面是移植的标准,请参考上面的老帖内容。里面还有移植后肝癌几乎0复发的条件。
• Hepatic resection should be considered as primary therapy in any patient with
HCC and a non-cirrhotic liver (including fibrolamellar variant) (evidence grade
IIa, recommendation grade B)
手术切除是肝癌加没有硬化患者的首选。
• Resection can be carried out in highly selected patients with hepatic cirrhosis
and well preserved hepatic function (Child-Pugh A). Such surgery carries a
high risk of post-operative decompensation and should be undertaken in units
with expertise in hepatic resection and management of liver failure and in
consultation with a liver transplant unit (evidence grade IIa, recommendation
grade B).
肝癌加硬化的可以切除,但必须严格(highly selected)筛选。而且这样的切除必须在有能力处置肝衰的医院进行并和肝移植专科讨论。
Non-surgical management
Non-surgical therapy should only be used where surgical therapy is not possible.
The techniques used are highly operator-dependant and should only be
undertaken in accredited HPB units with sufficient expertise.
非外科手术治疗仅在无法手术的情况下采用 。。。。。。。随后的内容看原文吧
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