HEPATECTOMY FOR HEPATIC METASTASES FROM BREAST CANCER

過去7年間で当科で経験した乳癌肝転移8例に対して肝切除術を施行し,肝切除の意義について検討した.乳癌肝転移8例の平均年齢は48.5歳で,腫瘍個数は単発例3例,多発例(3個以上) 5例,平均最大腫瘍径は3.6cmであった.術式は部分切除が4例,左葉切除が2例,右葉部分切除を伴った左葉切除,拡大S5亜区域切除がそれぞれ1例で,全例が重篤な術後合併症なく約2週間で退院した.肝切除後の1年生存率は87.5%, 3年生存率は33.3%で,腫瘍個数別の3年生存率は単発例が66.7%,多発例が0%で,単発例の生存率は有意に良好であった.残肝再発を3例に,他臓器再発を5例に認め,残肝再発症例の予後は不良であった.乳癌肝転移例においては単発例であれば長期生存例が期待できるので,切除可能であれば肝切除を施行すべきであるが,多発例では肝切除のみでは肝転移は制御できないと考えられた.

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