前瞻性临床实验肝癌病患肿瘤切除後由肝门脉辅助性化学药物.ppt

Recent Strategies in the Treatment of BCLC B and C HCC: In favor of Hepatic Resection as the First-line of Treatment NCNN guidelines The APASL recommendation 台灣肝癌醫學會2014肝癌診療共識 * Beyond the AASLD Guidelines… NCCN Guidelines for the Treatment of HCC (version 1.2016) Tumor size is not a determinant of hepatic resection Resection can be considered in patients with Limited and resectable multifocal disease In HCC with major vascular invasion National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology. 2016 Contents Agree (6 voters) If agree, please give score of E and R 2. 多發性肝癌若侷限於單一肝葉，仍可有機會給予治癒性切除。若多發性肝癌發生於兩側肝葉， 3顆病灶，且位於肝深部或肝門侵犯，則不適合切除。(E-2, R-B) 6/6 (100%) E-2 : 6 (100%) R-B: 5 (83%) A: 1 (17%) 台灣肝癌醫學會2014肝癌診療共識: Surgery (2) Ref (1) Ho MC, et al. Ann Surg Oncol 2009;16:848 (2) Ishizawa T, et al. Gastroenterology 2008;134:1908 (3) Yau T, et al. Gastroenterology 2014;146:1691 Contents Agree (6 voters) If agree, please give score of E and R 3. 肝癌單側門脈侵襲，仍可有機會給予治癒性切除。若發生門脈主幹侵襲或對側分支侵襲，則不適合切除。(E-2, R-B) 6/6 (100%) E-2 : 6 (100%) R-B: 5 (83%) C: 1 (17%) 台灣肝癌醫學會2014肝癌診療共識: Surgery (3) Ref (1) Liu PH, et al. Ann Surg Oncol 2014;21:1825 (2) Wu CC, et al. Arch Surg 2000;135:1273 (3) Chen XP, et al. Ann Surg Oncol 2006; 13:940 (4) Pawlik TM, et al. Surgery 2005; 137: 403 Contents Agree (6 voters) If agree, please give score of E and R 4. 肝癌發生單枝肝靜脈侵襲，仍可有機會給予治癒性切除。若發生下腔靜脈或右心室侵襲，則不適合切除。(E-2, R-B) 6/6 (100%) E-2 : 5 (83%) 3: 1 (17%) R-B: 5 (83%) C: 1 (17%) 台灣肝癌醫學會2014肝癌診療共識: Surgery (4) Ref (1) Wu CC, et al. Surgery 2012;151:223 (2) Kokudo T, et al. J Hepatology 2014;61:583 Contents Agree (6 voters) If agree, please give score of E and R 5. 肝癌發生單一器官肝外轉移，仍可有機會給予治癒性切除。若發生多處轉移或肝癌肝內病灶進展中，則不適合切除。(E-3, R-B) 6/6 (100%) E-2 : 3 (50%) 3: 3 (50%) R-B: 4 (67%) C: 2 (33%) 台灣肝癌醫學會2014肝癌診療共識: Surgery (5) Ref (1) Chan KM, et al. World J Ga