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Современные принципы лечения гепатоцеллюлярного рака

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Цель исследования: улучшить результаты лечения, качество и продолжительность жизни, прогноз у пациентов с гепатоцеллюлярным раком на основании анализа исходов лечения. Материал и методы. Проведен анализ отдаленных результатов лечения 114 больных гепатоцеллюлярным раком за 2015-2020 гг. Выделены 2 группы больных: в 1-ю группу (потенциально резектабельная опухоль в объеме R0) включили 41 (35,9%) больного, во 2-ю (распространенность опухоли не предполагает объем резекции R0) - 63 (55,2%) больных. Результаты. Актуариальная выживаемость пациентов после резекции R0 (48) составила: 1 год - 85%, 3 года - 65%, 5 лет - 55%; у нерезектабельных больных после трансартериальной химиоэмболизации: 1 год - 65%, 3 года - 29%, 5 лет - 11%; после локальных методов деструкции: полгода - 75%, 1 год - 36%, 1,5 года - 22%. Заключение. Результаты лечения больных гепатоцеллюлярным раком подтверждают целесообразность и эффективность рационального мультидисциплинарного подхода. Он позволяет добиваться удовлетворительных результатов в многопрофильных стационарах. Результаты совпадают с данными крупных хирургических центров.

Ключевые слова:
печень, гепатоцеллюлярный рак, классификация, лечение, отдаленные результаты, liver, hepatocellular carcinoma, classification, treatment, long-term results

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Modern principles of hepatocellular carcinoma treatment

Aim. To improve the treatment outcomes, quality and life expectancy, prognosis in patients with hepatocellular carcinoma based on an analysis of treatment outcomes. Materials and methods. The analysis of the long-term results of treatment of 114 patients with hepatocellular carcinoma for 2015-2020 was carried out. Two groups of patients were distinguished: 41 (35.9%) patients were included in group I (a potentially resectable tumor with R0 surgery), and 63 (55.2%) patients were included in group II (advanced tumor does not suggest R0 resection). Results. Actuarial survival for patients with R0 surgery (48) was: 1 year - 85%, 3 years - 65%, 5 years - 55%; in patients with unresectable tumor after transarterial chemoembolization: 1 year - 65%, 3 years - 29%, 5 years - 11%; after local destruction methods - 0.5 years - 75%, 1 year - 36%, 1.5 years - 22%. Conclusions. The results of treatment of patients with hepatocellular carcinoma confirm the feasibility and effectiveness of a rational multidisciplinary approach. It allows you to achieve satisfactory results in multidisciplinary hospitals. The results are consistent with the data of large surgical centers.

Keywords:
печень, гепатоцеллюлярный рак, классификация, лечение, отдаленные результаты, liver, hepatocellular carcinoma, classification, treatment, long-term results