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Abstract Objective To conclude the therapeutic efficacy of hepatectomy in combination with postoperative TACE for patients surviving over 10 years with hepatocellular carcinoma (HCC). Methods There were 613 HCC cases undergone hepatectomy combined with postoperative TACE during August, 2000 to April, 2017, in whom 53 cases survived more than 10 years, whose clinical data was analyzed retrospectively. In all the cases,41(77.4%)had hepatitis B background,39(73.6%)had hepatic cirrhosis, 44(83.0%)had AFP positive, and 49(92.5%) had used ASSS freezing hepatic remnant facet during operation. 31 cases(58.5%) with tumor diameter of 6～10cm,16(30.2%) of 10～15cm, and 6(11.3%) of 15～20 cm. 46 cases(86.8%) had complete tumor amicula. The tumor located in left liver of 16(30.2%),in right liver of 33(62.3%),and in the medial segment of 4(7.5%). 53(100%) had performed hepatic segmental resection. All the cases were performed with TACE 1, 2, 3, 6, 9, 12, 18 and 24 months after operation. AFP and upper abdominal CT were evaluated dynamically. 3(5.7%) had portal vein tumor thrombus in the 2 years following the procedure, and 5(9.4%) cases had local recurrence within 3 years after operation, which were cured by conformal therapy(photon knife). Results All the 44 AFP positive cases turned to negative(100%) after operation. There were 25 cases died 10 years after operation, in whom 15(60%)died from neoplasm recurrence and hepatic failure, 4(16%) died from gastrointestinal bleeding, 3(12%) died from pulmonary infection and cardiac accident, and 3(12%) died from urinary tract obstruction and infection. By the end of follow-up, the 10-, 11-, 12-, 13-, 14-,15-,17-year survival cases were 13(46.4%),3(10.7%),4(14.3%),3(10.7%),3(10.7%), 1(3.6%)and 1(3.6%). Conclusions ①Hepatectomy in combination with postoperative TACE can effectively improve the prognosis of patients suffering from HCC. ②Using ASSS freezing hepatic remnant facet during operation and postoperative conformal therapy(photon knife)can improve the prognosis of patients suffering from HCC.
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2018, Vol. 22 
