Clinical manifestations and survival of hepatocellular carcinoma patients with peritoneal metastasis

被引:43
作者
Lin, Chien-Chu [1 ,2 ]
Liang, Hsiao-Ping [3 ]
Lee, Hsuan-Shu [1 ]
Huang, Guan-Tarn [1 ]
Yang, Pei-Ming [1 ]
Ho, Ming-Chih [4 ]
Lee, Po-Huang [4 ]
Tsang, Yuk-Ming [5 ]
Chen, Ding-Shinn [1 ,6 ]
Sheu, Jin-Chuan [1 ]
Chen, Chien-Hung [1 ]
机构
[1] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 100, Taiwan
[2] Far Eastern Mem Hosp, Dept Internal Med, Taipei, Taiwan
[3] Natl Taiwan Univ Hosp, Bobson Obs Gyn Clin, Taipei 100, Taiwan
[4] Natl Taiwan Univ Hosp, Dept Surg, Taipei 100, Taiwan
[5] Natl Taiwan Univ Hosp, Dept Med Imaging, Taipei 100, Taiwan
[6] Natl Taiwan Univ Hosp, Hepatitis Res Ctr, Taipei 100, Taiwan
关键词
hepatocellular carcinoma; metastasis; peritoneum; treatment; PRIMARY LIVER-CANCER; INTRAPERITONEAL METASTASIS; EXTRAHEPATIC METASTASES; SPONTANEOUS RUPTURE; RESECTION; IMPLANTATION; FEATURES; JAPAN; CT;
D O I
10.1111/j.1440-1746.2009.05848.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Peritoneal metastasis is an uncommon manifestation of hepatocellular carcinoma (HCC). The aim of the present paper was to investigate the characteristics and survival of HCC patients with peritoneal metastases. From January 1985 to December 2004, we retrospectively reviewed the records of 53 Taiwanese HCC patients with peritoneal metastases. Peritoneal metastases were detected at the time of HCC diagnosis (synchronously) in 10 patients and after the initial therapy for the primary tumors (metachronously) in 43 patients. The mean time for development of the metachronous peritoneal metastases was similar whether the primary cancer was treated with surgery (24 months) or transarterial chemoembolization (22.2 months). The single patient whose primary cancer was treated with supportive care alone developed peritoneal metastasis only 7.5 months after detection of the primary cancer. Surgical resection of the peritoneal metastases was possible in two-thirds of the 43 metachronous patients. The median survival for those who received surgery for these metastases was 12.5 months vs. 2.1 months for those without surgery (P = 0.0013). However, there was no difference in survival if patients were stratified to Child-Pugh grade. Peritoneal metastases of HCC are rare and can occur synchronously or metachronously. Though increased long-term survival was found in patients who had surgical removal of peritoneal metastases, the main determinant of better survival is Child-Pugh grade.
引用
收藏
页码:815 / 820
页数:6
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