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肝细胞癌合并门静脉癌栓治疗现状与展望

张学文 戴朝六

引用本文:
Citation:

肝细胞癌合并门静脉癌栓治疗现状与展望

DOI: 10.3969/j.issn.1001-5256.2019.04.043
基金项目: 

2017年辽宁省重点研发计划指导计划项目(2017225032); 

详细信息
  • 中图分类号: R735.7

Current status and perspectives of the treatment of hepatocellular carcinoma with portal vein tumor thrombus

Research funding: 

 

  • 摘要: 门静脉癌栓是进展期肝细胞癌的常见并发症之一,严重影响肝癌患者的治疗和预后生存。近年来,随着外科手术方式、局部介入治疗、放射治疗、靶向药物治疗以及免疫治疗等学科的发展和进步,合并门静脉癌栓的进展期肝癌不再是临床治疗禁区,无论采取单一治疗方法或是联合治疗都取得了良好的效果。阐述了合并门静脉癌栓的进展期肝癌的治疗现状和治疗难点以及未来的治疗方向。

     

  • [1]CHEN W, ZHENG R, BAADE PD, et al.Cancer statistics in China, 2015[J].CA Cancer J Clin, 2016, 66:115-132.
    [2]ZHANG ZM, LAI EC, ZHANG C, et al.The strategies for treating primary hepatocellular carcinoma with portal vein tumor thrombus[J].Int J Surg, 2015, 20:8-16.
    [3]LEE JM, JANG BK, LEE Y J, et al.Survival outcomes of hepatic resection compared with transarterial chemoembolization or sorafenib for hepatocellular carcinoma with portal vein tumor thrombosis[J].Clin Mol Hepatol, 2016, 22:160-187.
    [4]JIA WD, LIU WB.Surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].J Clin Hepatol, 2015, 31 (6) :859-862. (in Chinese) 颊卫东, 刘文斌.肝细胞癌伴门静脉癌栓的手术治疗[J].临床肝胆病杂志, 2015, 31 (6) :859-862.
    [5]National Cooperative Group of Diagnosis and Treatment of Liver Cancer with Tumor Thrombus.Chinese expert consensus on multidisciplinary diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].Chin J Pract Surg, 2016, 36 (5) :475-480. (in Chinese) 全国肝癌合并癌栓诊治研究协作组.肝细胞癌合并门静脉癌栓多学科诊治中国专家共识 (2016年版) [J].中国实用外科杂志, 2016, 36 (5) :475-480.
    [6]CHEN ZY, YANG JM, GAO F.New progress in the diagnosis and treatment of hepatocellular carcinoma combined with portal vein tumor thrombus[J].Clin Med Chin, 2018, 34 (2) :186-189. (in Chinese) 陈梓洋, 杨建明, 高峰.肝癌伴门静脉癌栓诊断和治疗的新进展[J].中国综合临床, 2018, 34 (2) :186-189.
    [7]CHENG SQ, SUN JX, SHI J.Bottleneck and strategies in the treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].Chin J Dig Surg, 2018, 17 (5) :426-429. (in Chinese) 程树群, 孙居仙, 石洁.肝癌合并门静脉癌栓治疗的瓶颈与对策[J].中华消化外科杂志, 2018, 17 (5) :426-429.
    [8]CHEN P, LI F.New progress in treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].J Clin Hepatol, 2015, 31 (6) :974-976. (in Chinese) 陈鹏, 李菲.肝细胞癌合并门静脉癌栓治疗新进展[J].临床肝胆病杂志, 2015, 31 (6) :974-976.
    [9]DAI BS, YANG ZY, DU XL, et al.Research advances in the treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].Mod Oncol, 2018, 26 (10) :1619-1623. (in Chinese) 代柏树, 杨振宇, 杜锡林, 等.肝细胞癌合并门静脉癌栓的治疗进展[J].现代肿瘤医学, 2018, 26 (10) :1619-1623.
    [10]ZHU HB, LI JT.Progress in diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].World Chin J Dig, 2017, 25 (24) :2161-2166. (in Chinese) 朱焕兵, 李江涛.肝细胞癌合并门静脉癌栓的诊治进展[J].世界华人消化杂志, 2017, 25 (24) :2161-2166.
    [11]IKAI I, YAMAMOTO Y, YAMAMOTO N, et al.Results of hepatic resection for hepatocellular carcinoma invading major portal and/or hepatic veins[J].Surg Oncol Clin N Am, 2003, 12 (1) :65-75.
    [12]SHUQUN C, MENGCHAO W, HAN C, et al.Tumor thrombus types influence the prognosis of hepatocellular carcinoma with the tumor thrombi in the portal vein[J].Hepatogastroenterology, 2007, 54 (74) :499-502.
    [13] LIU YY.Hepatocellular carcinoma with portal vein tumor thrombosis:Deficiencies in the currently available classificatons[J].Chin J Dig Surg, 2018, 17 (5) :423-425. (in Chinese) 刘允怡.肝癌合并门静脉现存的不足[J].中华消化外科杂志, 2018, 17 (5) :423-425.
    [14]ZHANG XP, WANG K, ZHONG CQ, et al.Surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].J Hepatobiliary Surg, 2017, 25 (1) :14-17. (in Chinese) 张修平, 王康, 钟承千, 等.浅谈肝细胞癌合并门静脉癌栓的手术治疗[J].肝胆外科杂志, 2017, 25 (1) :14-17.
    [15] PENG ZW, GUO RP, ZHANG YJ, et al.Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with portal vein tumor thrombus[J].Cancer, 2012, 118 (19) :4725-4736.
    [16]ZHENG N, WEI X, ZHANG D, et al.Hepatic resection or transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus[J].Medicine (Baltimore) , 2016, 95 (26) :e3959.
    [17]WANG K, GUO WX, CHEN MS, et al.Multimodality treatment for hepatocellular carcinoma with portal vein tumor thrombus:A large-scale, multicenter, propensity mathching score analysis[J].Medicine (Baltimore) , 2016, 95 (11) :e3015.
    [18]SUN JX, SHI J, CHENG SQ.Difficulties in the diagnosis and treatment of liver cancer with portal vein tumor thrombus and related strategies[J].Chin J Pract Surg, 2016, 36 (6) :614-617. (in Chinese) 孙居仙, 石洁, 程树群.肝癌合并门静脉癌栓诊治难点及对策[J].中国实用外科杂志, 2016, 36 (6) :614-617.
    [19]LI N, FENG S, XUE J, et al.Hepatocellular carcinoma with main portal vein tumor thrombus:A comparative study comparing hepatectomy with or without neoadjuvant radiotherapy[J].HPB (Oxford) , 2016, 18 (6) :549-556.
    [20]YE JZ, ZHANG YQ, YE HH, et al.Appropriate treatment strategies improve survival of hepatocellular carcinoma patients with portal vein tumor thrombus[J].World J Gastroenterol, 2014, 20 (45) :17141-17147.
    [21]SUN JJ, WANG K, ZHANG CZ, et al.Postoperative adjuvant transcatheter arterial chemoembolization after R0 hepatectomy improves outcomes of patients who have hepatocellular carcinoma with microvascular invasion[J].Ann Surg Oncol, 2016, 23 (4) :1344-1351.
    [22]XUE TC, XIE XY, ZHANG L, et al.Transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus:A meta-analysis[J].BMC Gastroenterol, 2013, 13:60.
    [23]CHERN MC, CHUANG VP, LIANG CT, et al.Transcatheter arterial chemoembolization for advanced hepatocellular carcinoma with portal vein invasion:Safety, efficacy, and prognostic factors[J].J Vasc Interv Radiol, 2014, 25 (1) :32-40.
    [24]LIU KC, LYU WF, ZHOU CZ, et al.Curative effect and influencing factors of hepatocellular carcinoma with portal vein tumor thrombosis treated with TACE[J].Chin Interv Imaging Ther, 2018, 15 (6) :331-336. (in Chinese) 刘开才, 吕维富, 周春泽, 等.TACE治疗原发性肝细胞癌合并门静脉癌栓疗效及影响因素[J].中国介入影像与治疗学, 2018, 15 (6) :331-336.
    [25]YE HH, YE JZ, XIE ZB, et al.Comprehensive treatments for hepatocellular carcinoma with tumor thrombus in major portal vein[J].World J Gastroenterol, 2016, 22 (13) :3632-3643.
    [26]XI M, ZHANG L, ZHAO L, et al.Effectiveness of stereotactic body radiotherapy for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombosis[J].PLo S One, 2013, 8 (5) :e63864.
    [27]LI XL, GUO WX, HONG XD, et al.Efficacy of the treatment of transarterial chemoembolization combined with radiotherapy for hepatocellular carcinoma with portal vein tumor thrombus:Apropensity score analysis[J].Hepatol Res, 2016, 46 (11) :1088-1098.
    [28]LIN JJ, LU LJ, JIN XJ, et al.Effect of synchronous iodine-125 seed strand implantation and transcatheter arterial chemoembolization in the treatment of primary hepatocellular carcinoma combined with portal vein main tumor thrombus[J].China Med Herald, 2018, 15 (17) :85-88. (in Chinese) 林介军, 卢立杰, 金小军, 等.门脉内支架同步125I粒子条植入序贯经肝动脉化疗栓塞治疗原发性肝癌合并门脉癌栓的效果[J].中国医药导报, 2018, 15 (17) :85-88.
    [29]LIU Y, LIU R, WANG P, et al.Percutaneous implantation of (125) iodine seeds for treatment of portal vein tumor thrombosis in hepatocellular carcinoma[J].Med Oncol, 2015, 32 (8) :214.
    [30]HUANG M, LIN Q, WANG H, et al.Survival benefit of chemoembolization plus Iodine125 seed implantation in unresectable hepatitis B-related hepatocellular carcinoma with PVTT:Aretrospective matched cohort study[J].Eur Radiol, 2016, 26 (10) :3428-3436.
    [31]ZHANG W, YAN ZP.Better late than never:Discussion on the localization of yttrium-90 microsperes[J].J Intervent Radiol, 2017, 26 (10) :865-867. (in Chinese) 张雯, 颜志平.亡羊补牢-论钇-90微球国产化[J].介入放射学杂志, 2017, 26 (10) :865-867.
    [32]LAU WY, SANGRO B, CHEN PJ, et al.Treatment for hepatocellular carcinoma with portal vein tumor thrombosis:the emerging role for radioembolization using yttrium-90[J].Oncology, 2013, 84 (5) :311-3118.
    [33]CHEW V, LEE YH, PAN L, et al.Immune activation underlies a sustained clinical response to Yttrium-90 radioembolisation in hepatocellular carcinoma[J].Gut, 2019, 68 (2) :335-346.
    [34]Special Committee of Liver Cancer, Chinese Medical Doctor Association.Chinese expert consensus on the diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus (version 2018) [J].Chin J Pract Surg, 2019, 39 (1) :46-52. (in Chinese) 中国医师协会肝癌专业委员会.肝细胞癌合并门静脉癌栓多学科诊治中国专家共识 (2018年版) [J].中国实用外科杂志, 2019, 39 (1) :46-52.
    [35]ZHU XL.Comprehensive interventional treatment of hepatocellular carcinoma with portal vein tumor thrombosis[J].J Clin Hepatol, 2015, 31 (6) :863-869. (in Chinese) 朱晓黎.肝细胞癌伴门静脉癌栓的介入综合治疗[J].临床肝胆病杂志, 2015, 31 (6) :863-869.
    [36]LLOVET JM, RICCI S, MAZZAFERRO V, et al.Sorafenib in advanced hepatocellular carcinoma[J].N Engl J Med, 2008, 359 (4) :378-390.
    [37]CHENG AL, GUAN Z, CHEN Z, et al.Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma according to baseline status:Subset analyses of the phaseⅢSorafenib Asia-Pacific trial[J].Eur J Cancer, 2012, 48 (10) :1452-1465.
    [38]ZHU K, CHEN J, LAI L, et al.Hepatocellular carcinoma with portal vein tumor thrombus:Treatment with transarterial chemoembolization combined with sorafenib-A retrospective controlled studyl[J].Radiology, 2014, 272 (1) :284-293.
    [39]ZHANG X, WANG K, WANG M, et al.Transarterial chemoembolization (TACE) combined with sorafenib versus TACE for hepatocellular carcinoma with portal vein tumor thrombus:Asystematic review and meta-analysisl[J].Oncotarget, 2017, 8 (17) :29416-29427.
    [40]SUN B, YANG XZ, XIE F, et al.Effect of sorafenib combined with transcatheter arterial chemoembolization and radiofrequency ablation on the survival of patients with hepatocellular carcinoma[J].J Clin Hepatol, 2019, 35 (1) :104-108. (in Chinese) 孙斌, 杨晓珍, 谢放, 等.索拉非尼联合经肝动脉化疗栓塞术和射频消融对肝细胞癌患者生存期的影响[J].临床肝胆病杂志, 2019, 35 (1) :104-108.
    [41]JACKSON R, PSARELLI EE, BERHANE S, et al.Impact of viral status on survival in patients receiving sorafenib for advanced hepatocellular cancer:A Meta-analysis of randomized phase III trials[J].J Clin Oncol, 2017, 35 (6) :622-628.
    [42]BRUIX J, QIN S, MERLE P, et al.Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE) :A randomised, double-blind, placebo-controlled, phase 3 trial[J].Lancet, 2017, 389 (10064) :56-66.
    [43]KUDO M, FINN RS, QIN S, et al.Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma:A randomised phase 3 non-inferiority trial[J].Lancet, 2018, 391 (10126) :1163-1173.
    [44] WANG MD, WU H, YANG T.Research progress of primary liver cancer from 2017 annual meeting of Chinese Society of Clinical Oncology[J].Chin J Surg, 2017, 16 (11) :1109-1112. (in Chinese) 王明达, 吴寒, 杨田.2017年中国临床肿瘤学会年会原发性肝炎研究进展分析[J].中华消化外科杂志, 2017, 16 (11) :1109-1112.
    [45]QIN S, BAI Y, LIM HY, et al.Randomized, multicenter, open-label study of oxaliplatin plus fluorouracil/leucovorin versus doxorubicin as palliative chemotherapy in patients with advanced hepatocellular carcinoma from Asia[J].J Clin Oncol, 2013, 31 (28) :3501-3508.
    [46]REN ZG.Immunotherapy for hepatocellular carcinoma[J].JClin Hepatol, 2018, 34 (7) :1371-1373. (in Chinese) 任正刚.肝细胞癌的免疫治疗[J].临床肝胆病杂志, 2018, 34 (7) :1371-1373.
    [47]El-KHOUEIRY AB, SANGRO B, YAU T, et al.Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate040) :An open-label, non-comparative, phase 1/2 dose escalation and expansion trial[J].Lancet, 2017, 389 (10088) :2492-2502.
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