对肝癌肝切除术指证的新近认识.pptx.pptxVIP

;;; 终末期肝病模型(model for end stage liver disease, MELD) ; ;Fibroscan;[Kim, Hepatol Int, 2008];依靠肝功能的治疗选择;[Yamanaka, World J Surg 2007];[Clavien PA, NEJM 2007];[The JSH, Hepatology Res 2010];; 医生专业对治疗方式选择的影响有时超过疾病本身因素 ; 指南或共识 ;[NCCN Practice Guidelines in Oncology v.1.2010 /professionals/physician_gls/f_guidelines.asp];;;;超指南的手术切除治疗特征; 门脉高压症对肝癌肝切除的影响的影响;Conventional Indications (BCLC A1); 术前门脉高压对肝切除预后的影响（626例，EHBH）; 单因素分析; ; 门静脉癌栓对肝切除预后的影响;;; Only cohort studies with including patients with mixed features -5-yr survival ranging from 24 to 58% -5-yr disease-free survival ranging from 0 to 26% ;;Whatever TNM, CLIP and BCLC staging systems is applied;[Wang.J Formos Med Assoc 2008]; ; ; 预测多发性肝癌术后生存的评分系统 ;分期;大肝癌的肝切除术;[Livraghi T, Hepatology 2008];早期肝癌手术与微创治疗 ;肝癌的腹腔镜肝切除术：数量激增;荟萃分析： 21 项研究(1998-2010) 494 例HCC患者 LLR 213 / OLR 281; 小 结;谢 谢 !