肝癌微波消融医学课件.pptVIP

* Title: Current strategy for staging and treatment: the BCLC update and future prospects. Abstract: Staging and treatment indication are relevant topics in the management of patients with hepatocellular carcinoma (HCC) and for optimal results, they have to take into account liver function, tumor stage, and physical status. For any staging system to be meaningful it has to link staging with treatment indication; this should be based on robust scientific data. Currently, the sole proposal that serves both aims is the Barcelona Clinic Liver Cancer (BCLC) approach. It takes into account the relevant parameters of all important dimensions and divides patients into very early/early, intermediate, advanced, and end-stage. Early-stage HCC patients should be considered for potentially curative options such as resection, ablation, and transplantation. Patients at intermediate stage benefit from chemoembolization, whereas patients at an advanced stage, or who cannot benefit from options of higher priority, have sorafenib as the standard treatment. Finally, patients at end-stage should merely receive palliative care. * 内容包括前言，研究目的、对象和方法、结果、讨论、结论及致谢。 * 内容包括前言，研究目的、对象和方法、结果、讨论、结论及致谢。 * 内容包括前言，研究目的、对象和方法、结果、讨论、结论及致谢。 微波射频消融 * 中国是肝癌发病重灾区 0 3.0 5.3 8.3 17.6 117 Age-standardised incidence rates per 100,000 男性发病率:34.7/100,000（292,966例） 女性发病率:13.7/100,000（109,242 例） 男性死亡率:34.1/100,000（226,830例） 女性死亡率:13.1/100,000（105,249例） 占全球病人的55% * 消融术 0期PST 0, Child–Pugh A级 极早期（0） 1 HCC 2cm原位癌 早期 (A) 1个 HCC或3个结节 3cm，PST 0 晚期 (C) 门脉侵犯， N1, M1, PST 1–2 终末期 (D) 肝移植 TACE 手术切除 对症治疗 根治疗法 姑息疗法 相关疾病 有 无 3 个结节 ≤3cm 升高 正常 1个 HCC 门脉压力/胆红素 D期PST 2, Child–Pugh C级 HCC 中期 (B) 多结节，PST 0 A–C期PST 0–2, Child–Pugh A–B级 索拉非尼 5年生存率：50%-70% 3年生存率：10%-40% 生存期3个月 8. Forner A, et al. Semin Liver Dis 2010;30:61-74. 9. Bruix J et al. The Lancet 2009;373(9664):614-616 BCLC 分期系统及治疗策略（2010） 肝移植 手术切除 消融术 肝移植 手术切除 TACE 索拉非尼 消融术 肝移植 手术切除 对症治疗 根治疗法 姑息疗法 TACE 索拉非尼 消融术 肝移植 手术切除 * 调查结果：八成肝癌患者为中晚期 A期 B期 C期 D期 53.