肝臟的第二種原發性癌症－肝內膽管癌

10.6666/ClinMed.2017.79.3.025

雷浩然；周嘉揚；夏振源；金光亮

肝內膽管癌(intrahepatic cholangiocarcinoma) ； 肝臟手術(liver resection、hepatectomy) ； 肝門淋巴結清除(hilum lymph node dissection)

臨床醫學月刊

79卷3期（2017 / 03 / 31）

134 - 140

繁體中文

肝內膽管癌是肝內第二常見的原發性癌症。其發生率不到肝癌的十分之一，但是近年來似乎有逐漸上升的趨勢。手術切除是唯一可以提供治癒機會的治療方式，手術後五年存活率約為14- 40%。淋巴結轉移和手術邊緣腫瘤殘留是影響預後最重要的兩個因素。雖然目前無法證實常規術後輔助治療可以增加病患存活率，但在大部分臨床治療指引中對於上述這兩類病患仍建議應積極給予術後輔助性治療以減低復發的機會。對於多發性腫瘤、大型腫瘤、腫瘤位置近肝門部以及術前血清檢測CEA或CA199濃度高的病患，手術中可考慮進行肝門淋巴結廓清術以正確診斷是否有淋巴結的轉移。對於因為肝功能不良而無法進行手術切除的病患，如果是小型的早期腫瘤可考慮進行肝移植，但需要在有經驗的醫學中心審慎評估及進行手術。

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