【摘要】 目的 探索原发性肝癌（简称肝癌）患者外科治疗获得长期高质量生存之路。方法 回顾性分析复旦大学附属中山医院1958年7月至1995年9月间外科切除治疗后生存30年以上、资料最完整、最有代表性、病理证实的10例肝癌患者的诊治经过及随访结果，结合文献资料总结成功经验。结果 例1，男，50周岁。肝癌切除术后长期生存43年，最早突破肝癌生存40年大关。例2，女，36周岁。肝癌切除术后无瘤生存57年，系肝切除术后最长期生存者。例3，男，31周岁。巨大肝癌（直径17 cm）切除术后无瘤生存51年。例4，男，19周岁。20世纪70年代因甲胎蛋白异常升高怀疑为肝癌，接受开腹探查和肝癌切除治疗，无瘤生存50年，健在。例5，男，59周岁。因肝癌先后接受两次手术：肝癌切除术和肺转移癌切除术。术后平顺，未再复发与转移，生存43年。该患者年老病逝，终年103周岁，为肝癌术后最长寿者。例6，女，19周岁。于20世纪70年代肝癌筛查时发现甲胎蛋白异常升高，接受开腹探查及肝癌切除治疗，无瘤生存50年。术后生育一女，母女健在。例7，男，44周岁。因肝右叶巨块型肝癌，先后接受3次手术：肝动脉结扎插管术、肝癌切除术、复发肝癌切除术。术后生存45年，健在。例8，男，57周岁。因肝癌伴肝静脉癌栓接受一次性肝癌连同癌栓切除治疗，无瘤生存38年，健在。例9，男，48周岁。系肝门区肝癌，接受一次性肝癌根治性切除术后无瘤生存32年，健在。例10，女，18个月。因腹部肿块就诊，该患者甲胎蛋白异常升高，腹部CT检查显示肝癌影像特征。肝癌切除术后无瘤生存32年，已先后生育两男孩，最近一次随访时母子健在。结论 外科切除治疗是肝癌患者最关键和最彻底的治疗手段，能使患者获得长期生存，甚至获得奇迹般的疗效。更多还原

【Abstract】 Objective Exploring the way to obtain long-term, high-quality survival of patients with primary liver cancer(PLC) by surgical resection. Method Reviewing the diagnosis, treatment and follow-up outcomes of 10 PLC patients who were most representative, confirmed by pathology and survived for 30 years or more after surgical treatment at Zhongshan Hospital, Affiliated to Fudan University from July 1958 to September 1995, and summarizing the successful experiences with references. Results Case one: male, 50-year-old. Case one survived for forty-three years of long-term survival after surgery, who was the ealiest one to break the 40-year survival barrier. Case 2: female, 36-year-old. Case 2 had remained tumor-free survival for 57 years after liver resection: the longest record of high-quality survival to date. Case 3:male, 31-year-old. Case 3 had remained 51-year tumor-free survival after resection of a giant(17 cm) hepatocellular carcinoma. Case 4: male, 19-year-old. The patient, suspected of liver cancer based only on abnormally elevated alphafetoprotein(AFP) in the 1970s, underwent surgical exploration with immediate liver cancer resection, and had since enjoyed 50 years of tumor-free survival. Case 5: male, 59-year-old. The patient survived to be 103 years old after undergoing liver cancer resection and subsequent pulmonary metastasis resection with tumor-free survival of 43 years.Case 6: female, 19-year-old. The patient survived 50 years after undergoing liver cancer resection. Her liver cancer was found on abnormally elevated AFP in liver cancer screening in the 1970s. She gave birth to a healthy baby girl 10 years after the operation. Now the mother and daughter lead a happy life. Case 7: male, 44-year-old. The patient with a massive liver cancer undervent three sequential surgical interventions: hepatic artery ligation and cannulation, hepatectomy for the primary tumor, and re-resection of recurrent tumor. He had survived for 45 years postoperatively and well. Case 8: male,57-year-old. The patient with liver cancer accompanied by thrombus in the left hepatic vein and survived for 38 years after undergoing an En Bloc liver cancer resection including removal of the cancer thrombus. Case 9: male, 48-year-old. The patient with hilar liver cancer(segment Ⅷ) had been living healthily for 32 years after a thrilling liver resection. Case 10:18-month-old, baby girl. The female infant survived 32 years after undergoing liver cancer resection. Now she had grown up, gotten married, had her own children, and the family is living a happy life. Conclusion Surgical resection is the most thorough treatment method, enabling liver cancer patients to achieve long-term or even miraculous survival outcomes.更多还原