Serial therapies oriented by surgery for large primary XXXX .

@entity1 @entity18200 @entity6285 @entity7312 @entity96 @entity5 @entity535 @entity1416 @entity1139 @entity1578 @entity1068
OBJECTIVE: To discuss the methods and effects of serial therapies oriented by surgery in the treatment of primary large @entity96 . METHODS: From January 1993 to June 1999, 191 @entity1 with large @entity96 were treated surgically. The size of @entity5 varied from 5.2 to 19.7 cm (mean 9.4 cm). Several types of liver resections were made in 121 @entity1 and as a supplement, cryosurgery was carried out for the remaining 70 @entity1 . Importable drug delivery system was instituted intraoperatively. Transcatheter @entity1416 ( @entity7312 30-60 mg, E-ADM 20-40 mg, CDDP 40-80 mg, @entity1139 10-20 mg, iodin oil 5-30 ml), percutaneous @entity1068 injection, bioimmunotherapy and traditional Chinese medicine were used pre- and post-operatively. CT angiography and CT during arterial portography were used to find satellite nodules. Early stage recurrences were predicted by AFPmRNA in peripheral blood. @entity1 -Pugh's classification plus branch chain @entity535 /aromatic @entity535 ratio ( @entity18200 /AAA) was adopted in evaluating pre-operative liver functions. RESULTS: Marked results were observed after serial treatments oriented by surgery. The 1-, 3- and 5-year survival rates in resection group were 75.8%, 45.6% and 30.4%, respectively. The 1- and 3-year survival rates in cryosurgery group were 63.2% and 37.0%. The operative mortality was 1.57%. Recurrence rates were 69.2% in AFPmRNA positive group and 33.3% in AFPmRNA negative group (P<0.05). The @entity18200 / @entity6285 ratio was lower than 1.5 in two @entity1 who died of @entity1578 after resection. CONCLUSIONS: Serial treatments with surgery as the chief modality gives satisfactory results in @entity1 with large primary @entity96 . This regimen should be regarded as a main strategy to deal with large @entity96 . AFPmRNA in the peripheral blood, signifying a recurrence, may become a new clinical parameter. The @entity18200 /AAA ratio plus @entity1 -Pugh's classification is able to evaluate more accurately liver function reserve before surgery.
