本書通過介紹復(fù)旦大學(xué)附屬中山醫(yī)院1961-1995年收治的、88例肝癌術(shù)后20～48年長期生存的實(shí)例，分析這88例肝癌長期生存概況，總結(jié)肝癌長期生存的八條經(jīng)驗(yàn)及治療途徑，從而提出我國外科學(xué)者對肝癌本質(zhì)的認(rèn)識，非規(guī)則性肝切除是最主要的肝癌治療模式，肝動脈手術(shù)與肝癌二步切除治療是獨(dú)具特色的肝癌治療模式。本書以熟練的英文面向全球肝癌外科學(xué)者全面介紹了88例肝癌的治療經(jīng)過、成功經(jīng)驗(yàn)、技術(shù)要點(diǎn)和作者對肝癌外科內(nèi)涵的理解。其寫作力求深入淺出、圖文并茂，可供腫瘤外科醫(yī)師、青年醫(yī)師以及醫(yī)學(xué)生參考閱讀。
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Contents
Part I Eighty-Eight Illustrative Cases 1
Case 1 Recurrence 39 Years after Resection, Total Survival 43 Years 3
Case 2 A Single Resection, Ongoing Survival 48 Years 7
Case 3 Two Resections, Total Survival 44 Years 10
Case 4 A Single Resection, Total Survival 26 Years 12
Case 5 A Single Resection, Total Survival 34 Years 13
Case 6 A Single Resection of Giant Liver Cancer, Ongoing Survival 44 Years 14
Case 7 A Single Resection, Total Survival 20 Years 15
Case 8 Liver Resection and Resection of Pulmonary Metastasis, Total Survival 32 Years 16
Case 9 Two Resections, Ongoing Survival 40 Years 17
Case 10 Liver Resection and Resection of Pulmonary Metastasis, Total Survival 25 Years 18
Case 11 A Single Resection, Ongoing Survival 40 Years 19
Case 12 Oldest Survivor, Age 99, after Liver Resection and Subsequent Pulmonary Metastasis Resection, Ongoing Survival 40 Years 20
Case 13 A Single Resection, Ongoing Survival 40 Years 22
Case 14 A Single Resection, Total Survival 31 Years 23
Case 15 A Single Resection, Total Survival 34 Years 24
Case 16 A Single Resection, Ongoing Survival 36 Years 25
Case 17 A Single Resection, Total Survival 25 Years 26
Case 18 A Single Resection, Ongoing Survival 36 Years 27
Case 19 A Single Resection, Total Survival 29 Years 28
Case 20 A Single Resection, Ongoing Survival 35 Years 30
Case 21 A Single Resection, Ongoing Survival 35 Years 31
Case 22 Two-Step Resection and Resection of Recurrence, Ongoing Survival 35 Years 33
Case 23 A Single Resection, Ongoing Survival 34 Years 36
Case 24 Hepatic Artery Ligation and Cannulation with Infusion Hemotherapy, Ongoing Survival 32 Years 37
Case 25 A Single Resection, Total Survival 30 Years 38
Case 26 A Single Resection, Ongoing Survival 31 Years 39
Case 27 Two Resections, Ongoing Survival 31 Years 41
Case 28 Two Resections and Resection of Pulmonary Metastasis, Total Survival 20 Years 43
Case 29 A Single Resection, Ongoing Survival 31 Years 44
Case 30 A Single Resection, Total Survival 21 Years 45
Case 31 A Single Resection, Total Survival 26 Years 46
Case 32 Two-Step Resection, Total Survival 26 Years 47
Case 33 A Single Resection, Total Survival 28 Years 49
Case 34 A Single Resection, Ongoing Survival 30 Years 50
Case 35 Hepatic Artery Ligation and Cannulation with Infusion Chemotherapy, Total Survival 25 Years 51
Case 36 A Single Resection, Ongoing Survival 29 Years 52
Case 37 A Single Resection, Total Survival 20 Years 53
Case 38 Two-Step Resection, Ongoing Survival 29 Years 55
Case 39 A Single Resection, Ongoing Survival 29 Years 57
Case 40 A Single Resection, Ongoing Survival 29 Years 58
Case 41 Two Resections, Ongoing Survival 29 Years 59
Case 42 Two-Step Resection and Resection of Pulmonary Metastasis, Ongoing Survival 28 Years 60
Case 43 Two-Step Resection, Ongoing Survival 28 Years 64
Case 44 Two Resections, Total Survival 25 Years 65
Case 45 Two Resections, Ongoing Survival 28 Years 66
Case 46 Two Resections, Total Survival 27 Years 68
Case 47 Liver Resection and Hepatic Vein Cancer Thrombectomy, Ongoing Survival 28 Years 69
Case 48 Liver Resection and Bile Duct Cancer Thrombectomy, Total Survival 25 Years 71
Case 49 A Single Resection, Ongoing Survival 28 Years 72
Case 50 Liver Resection and Portal Vein Cancer Thrombectomy, Ongoing Survival 27 Years 73
Case 51 Two-Step Resection, Ongoing Survival 27 Years 75
Case 52 A Single Resection, Ongoing Survival 27 Years 77
Case 53 A Single Resection, Ongoing Survival 27 Years 78
Case 54 A Single Resection, Total Survival 26 Years 80
Case 55 Two-Step Resection, Ongoing Survival 26 Years 81
Case 56 A Single Liver Resection, Ongoing Survival 24 Years 82
Case 57 Two-Step Resection and Resection of Recurrence, Ongoing Survival 24 Years 83
Case 58 Resection of Bilateral Lesions, Ongoing Survival 23 Years 88
Case 59 Liver Resection and Hepatic Vein Cancer Thrombectomy, Ongoing Survival 23 Years 89
Case 60 A Single Resection, Ongoing Survival 23 Years 91
Case 61 A Single Resection, Ongoing Survival 23 Years 93
Case 62 A Single Resection, Ongoing Survival 23Years 94
Case 63 A Single Resection, Total Survival 22 Years 96
Case 64 A Single Resection, Ongoing Survival 22 Years 97
Case 65 Liver Resection for Metastases from Colon Cancer, Ongoing Survival 22 Years 99
Case 66 Resection of Hepatic Hilum Cancer, Ongoing Survival 22 Years 101
Case 67 A Single Resection, Ongoing Survival 22 Years 104
Case 68 A Single Resection, Ongoing Survival 22 Years 105
Case 69 A Single Resection in an 18 Months Child, Ongoing Survival 22 Years 106
Case 70 A Single Resection, Ongoing Survival 22 Years 108
Case 71 A Single Resection, Ongoing Survival 22 Years 109
Case 72 Liver Resection for Metastasis from Colon Cancer, Total Survival 21 Years 110
Case 73 A Single Resection, Ongoing Survival 21 Years 111
Case 74 A Single Resection, Ongoing Survival 21 Years 113
Case 75 Three Resections, Ongoing Survival 21 Years 114
Case 76 A Single Resection, Ongoing Survival 21 Years 117
Case 77 A Single Resection, Ongoing Survival 21 Years 118
Case 78 A Single Resection, Ongoing Survival 21 Years 119
Case 79 Two Resections, Ongoing Survival 21 Years 120
Case 80 A Single Resection, Ongoing Survival 20 Years 121
Case 81 Two Resections, Ongoing Survival 20 Years 122
Case 82 A Single Resection, Ongoing Survival 20 Years 124
Case 83 A Single Resection, Ongoing Survival 20 Years 125
Case 84 A Single Resection, Ongoing Survival 20 Years 126
Case 85 Two Resections, Ongoing Survival 20 Years 128
Case 86 A Single Resection, Ongoing Survival 20 Years 130
Case 87 A Single Resection, Ongoing Survival 20 Years 131
Case 88 Two-Step Resection of Liver Lymphoma, Ongoing Survival 20 Years 132
Part II Profile of 88 Cases with Long-Term Survival 135
Part III Gems to Take Home Experiences and Therapeutic Approaches 137
3.1 Hepatectomy is the Most Important Treatment for Liver Cancer. Long-Term Survival is Possible after a Single Liver Resection 139
3.2 Follow-Up Treatment with Resection of Recurrence Can Further Improve Therapeutic Efficacy 140
3.3 Long-Term Survival after 3 Successive Hepatectomies for Liver Cancer Further Strengthened the Value of Follow-up Treatment 142
3.4 Long-Term Survival after Liver Cancer Resection and Resection of Pulmonary Metastasis Again Highlighted the Value of Follow-up with Definitive Treatment 143
3.5 Long-Term Survival by Two-Step Liver Resection after Hepatic Artery Ligation with Cannulation and Intra-Arterial Infusion Chemotherapy to “Modify” the Cancer 145
3.6 Liver Resection with or Followed by Local Treatment for Liver Cancer is a New Approach to Prolong Survival 146
3.7 Long-Term Survival after Hepatectomy with Transcatheter Arterial Chemoembolization for Liver Cancer 148
References 152
Part IV Food for Thought on the Nature of Liver Cancer 155
4.1 Liver Cancer is a Systemic Disease as well as Local Disease. 156
4.2 Liver Cancer is a “Erocious Tiger” as well as a “Big Docile Cat” 157
4.3 Lung Metastasis Means the Disease is in a Late Stage, is not Entirely True 158
4.4 Do not Ignore the Value of Hepatic Artery Surgery in the Treatment of Liver Cancer 159
4.5 Multi-Modality Therapy is the Developing Trend, but Surgical Resection is Absolutely Irreplaceable in the Comprehensive Treatment 160
References 162
Part V Irregular Hepatectomy—the Mainstay Procedure in Liver Cancer Resection 163
5.1 Regular Hepatectomy 164
5.2 Irregular Hepatectomy 165
5.3 Application of Lip-Shaped Hepatectomy in Irregular Hepatectomy 166
5.4 Left Regular and Right Irregular Principle 171
5.5 Irregular Hepatectomy is Particularly Suitable for Liver Cancer at the Hepatic Hilum 171
5.6 Positive Evaluation of the Hepatic Hilum Occlusion Technique in Hepatectomy 173
5.7 The Concept of Radical Resection in Liver Cancer is Different from Other Solid Tumors 175
5.8 One Must Balance Outcome and Operative Risks 176
5.9 Suggestions to Reduce Mortality 177
References 180
Part VI Hepatic Artery Procedure and the Two-Step Resection for Liver Cancer 183
6.1 Mechanism of Hepatic Artery Procedure in the Treatment of Primary Liver Cancer 184
6.2 Hepatic Artery Ligation 185
6.3 Hepatic Artery Cannulation 187
6.4 Hepatic Artery Ligation with Cannulation 188
6.5 Operation in Detail 189
6.6 The Embedded Pump-Catheter Infusion System 191
6.7 Hepatic Intra-Arterial Chemotherapy via the Pump-Catheter System 193
6.8 Transcatheter Arterial Chemoembolization(TACE) 196
6.9 Two-Step Resection of Liver Cancer 197
6.10 Typical Cases in Hepatic Artery Therapy 198
References 210
Part VII Is Elevated Liver Enzymes in Liver Cancer a Surgical Contraindication? 213
References 218
Part VIII Challenges and Our Preliminary Efforts 219
References 229
Acknowledgement 231
Index 233
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