hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2020215-26hepato-619Research ArticleГЕПАТОЦЕЛЛЮРНЫЙ РАК. ДИАГНОСТИКА И ЛЕЧЕНИЕHEPATOCELLULAR CARCINOMA: DIAGNOSIS AND TREATMENTСовременные принципы лечения гепатоцеллюлярного ракаModern principles of hepatocellular carcinoma treatmenthttps://orcid.org/0000-0001-5039-4958ВишневскийВ. А.VishnevskyV. A.

Вишневский Владимир Александрович – доктор медицинских наук, профессор, советник директора

117997, Москва, ул. Большая Серпуховская, д. 27

Vladimir A. Vishnevsky – Doct. of Sci. (Med.), Professor, Advisor to the Director

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

vishnevskyva@ixv.ruhttps://orcid.org/0000-0002-4115-6963АйвазянХ. А.AyvazyanKh. A.

Айвазян Хачик Акопович – младший научный сотрудник отделения онкологии

117997, Москва, ул. Большая Серпуховская, д. 27

Khachik H. Ayvazyan – Junior Researcher of the Oncology Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

ayvazyan@ixv.ruhttps://orcid.org/0000-0003-1552-4969ИкрамовР. З.IkramovR. Z.

Икрамов Равшан Зияевич – доктор медицинских наук, главный научный сотрудник отделения онкологии

117997, Москва, ул. Большая Серпуховская, д. 27

Ravshan Z. Ikramov – Doct. of Sci. (Med.), Chief Researcher of Oncology Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

ikramov@ixv.ruhttps://orcid.org/0000-0002-4903-5293ИонкинД. А.IonkinD. A.

Ионкин Дмитрий Анатольевич – кандидат медицинских наук, врач-хирург отделения онкологии

117997, Москва, ул. Большая Серпуховская, д. 27 

Dmitry A. Ionkin – Cand. of Sci. (Med.), Surgeon of the Oncology Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

da.ionkin@gmail.comhttps://orcid.org/0000-0001-7720-5520ЖаворонковаО. И.ZhavoronkovaO. I.

Жаворонкова Ольга Ивановна – кандидат медицинских наук, старший научный сотрудник отделения ультразвуковой диагностики

117997, Москва, ул. Большая Серпуховская, д. 27

Olga I. Zhavoronkova – Cand. of Sci. (Med.), Senior Researcher, Ultrasound Diagnostics Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

zhavoronkovaoi@yandex.ruhttps://orcid.org/0000-0002-5793-5160СтепановаЮ. А.StepanovaYu. A.

Степанова Юлия Александровна – доктор медицинских наук, ученый секретарь

117997, Москва, ул. Большая Серпуховская, д. 27

Yulia A. Stepanova – Doct. of Sci. (Med.), Scientific Secretary

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

stepanovaua@mail.ruhttps://orcid.org/0000-0002-4016-8604ВараваА. Б.VaravaA. B.

Варава Алексей Борисович – младший научный сотрудник отдела рентгенэндоваскулярной хирургии

117997, Москва, ул. Большая Серпуховская, д. 27

Alexey B. Varava – Junior Researcher of the Interventional Surgery Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

varava@ixv.ruhttps://orcid.org/0000-0002-6128-1737КоваленкоЮ. А.KovalenkoYu. A.

Коваленко Юрий Алексеевич – доктор медицинских наук, старший научный сотрудник отделения онкологии

117997, Москва, ул. Большая Серпуховская, д. 27

Yuri A. Kovalenko – Doct. of Sci. (Med.), Senior Researcher of the Oncology Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

kovalenkoya@rambler.ruhttps://orcid.org/0000-0001-9636-3807ЖариковЮ. О.ZharikovYu. O.

Жариков Юрий Олегович – кандидат медицинских наук, доцент кафедры анатомии

129090, Москва, Большая Сухаревская пл., 3, корп. 1

Yuri O. Zharikov – Cand. of Sci. (Med.), Associate professor of the Anatomy Department

3, bldg. 1, Bolshaya Sukharevskaya sq., Moscow, 129090

dr_zharikov@mail.ruhttps://orcid.org/0000-0002-3528-036XГончаровА. Б.GoncharovA. B.

Гончаров Антон Борисович – младший научный сотрудник отделения онкологии

117997, Москва, ул. Большая Серпуховская, д. 27

Anton B. Goncharov – Junior Researcher of the Oncology Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

goncharov@ixv.ruhttps://orcid.org/0000-0002-1788-9681ОлифирА. А.OlifirA. A.

Олифир Анна Александровна – аспирант по специальности “хирургия”

117997, Москва, ул. Большая Серпуховская, д. 27

Anna A. Olifir – Graduate Student in Surgery

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

vatlat@yandex.ruhttps://orcid.org/0000-0001-8335-9921ПахомоваА. Ю.PakhomovaA. Yu.

Пахомова Анастасия Юрьевна – клинический ординатор по специальности “хирургия”

117997, Москва, ул. Большая Серпуховская, д. 27

Anastasia Y. Pakhomova – Clinical Resident in Surgery

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

drpakhomova@gmail.comhttps://orcid.org/0000-0003-0379-0135БугаевС. А.BugaevS. A.

Бугаев Сергей Анатольевич – кандидат медицинских наук, советник директора

117997, Москва, ул. Большая Серпуховская, д. 27

Sergey A. Bugaev – Cand. of Sci. (Med.), Adviser to the Director

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

s.bugaev.alsurg@gmail.comhttps://orcid.org/0000-0002-0204-8337ЧжаоА. В.ZhaoA. V.

Чжао Алексей Владимирович – доктор медицинских наук, профессор, заместитель директора

117997, Москва, ул. Большая Серпуховская, д. 27

Alexey V. Zhao – Doct. of Sci. (Med.), Professor, Deputy Director

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997

chzhao@ixv.ruФГБУ “Национальный медицинский исследовательский центр хирургии им. А.В. Вишневского” Минздрава РоссииVishnevsky National Medical Research Center of SurgeryИнститут клинической медицины им. Н.В. Склифосовского ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава РоссииSklifosovsky Institute of Clinical Medicine of I.M. Sechenov First Moscow State Medical University2020300420202521526Copyright © Вишневский В.А., Айвазян Х.А., Икрамов Р.З., Ионкин Д.А., Жаворонкова О.И., Степанова Ю.А., Варава А.Б., Коваленко Ю.А., Жариков Ю.О., Гончаров А.Б., Олифир А.А., Пахомова А.Ю., Бугаев С.А., Чжао А.В., 20202020Вишневский В.А., Айвазян Х.А., Икрамов Р.З., Ионкин Д.А., Жаворонкова О.И., Степанова Ю.А., Варава А.Б., Коваленко Ю.А., Жариков Ю.О., Гончаров А.Б., Олифир А.А., Пахомова А.Ю., Бугаев С.А., Чжао А.В.Vishnevsky V.A., Ayvazyan K.A., Ikramov R.Z., Ionkin D.A., Zhavoronkova O.I., Stepanova Y.A., Varava A.B., Kovalenko Y.A., Zharikov Y.O., Goncharov A.B., Olifir A.A., Pakhomova A.Y., Bugaev S.A., Zhao A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/619Цель исследования

Цель исследования: улучшить результаты лечения, качество и продолжительность жизни, прогноз у пациентов с гепатоцеллюлярным раком на основании анализа исходов лечения.

Материал и методы

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

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

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.

Aim

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

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

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

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.

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The authors declare that there are no conflicts of interest present.