rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2409-2231-2020-7-2-14rpmj-548Research ArticleКлинические наблюденияClinical Case ReportsКомбинированные обширные резекции печени у больных местнораспространенным гепатоцеллюлярным раком – клинические случаиCombined extensive liver resections in patients with locally advanced hepatocellular cancer – clinical caseshttps://orcid.org/0000-0002-8282-9351СидоровД. В.SidorovD. V.

Сидоров Дмитрий Владимирович – доктор медицинских наук, руководитель отделения абдоминальной онкологии

125284, г. Москва, 2-й Боткинский проезд, д. 3

SPIN: 1670-3690

AuthorID: 642999

Dmitrii V. Sidorov – Dr. Sci. (Med.), head of the department of abdominal oncology

3 2nd Botkinskiy travel, Moscow 125284

SPIN: 1670-3690

AuthorID: 642999 

dvsidorov_65@mail.ruhttps://orcid.org/0000-0003-1125-1131ЛожкинМ. В.LozhkinM. V.

Ложкин Михаил Владимирович – кандидат медицинских наук, ведущий научный сотрудник отделения абдоминальной онкологии

125284, г. Москва, 2-й Боткинский проезд, д. 3

SPIN: 4982-5909

AuthorID: 652950

Mikhail V. Lozhkin – Cand. Sci. (Med.), leading researcher of the department of abdominal oncology

3 2nd Botkinskiy travel, Moscow 125284

SPIN: 4982-5909

AuthorID: 652950 

https://orcid.org/0000-0001-6272-9647ПетровЛ. О.PetrovL. O.

Петров Леонид Олегович – кандидат медицинских наук, заведующий отделением лучевого и хирургического лечения заболеваний абдоминальной области

249035, г. Обнинск, ул. Королева, д. 4

SPIN: 4559-3613

AuthorID: 665865 

Leonid O. Petrov – Cand. Sci. (Med.), head of department of radiation and surgical treatment of abdominal diseases

4 Korolev str., Obninsk 249036

SPIN: 4559-3613

AuthorID: 665865

https://orcid.org/0000-0002-3038-5904ИсаеваА. Г.IsaevaA. G.

Исаева Аиша Гасановна – младший научный сотрудник

249035, г. Обнинск, ул. Королева, д. 4

SPIN: 7121-6391

AuthorID: 945036 

Aisha G. Isaeva – assistant research fellow

4 Korolev str., Obninsk 249036

SPIN: 7121-6391

AuthorID: 945036

https://orcid.org/0000-0002-0036-9241ГусаковаМ. С.GusakovaM. S.

Гусакова Мария Сергеевна – клинический ординатор

125284, г. Москва, 2-й Боткинский проезд, д. 3

Mariya S. Gusakova – resident physician

3 2nd Botkinskiy travel, Moscow 125284

МНИОИ им. П.А.Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской ФедерацииРоссияP.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological CentreRussian FederationМРНЦ им. А.Ф.Цыба – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской ФедерацииРоссияA.F.Tsyb Medical Radiological Research Center – Branch of the National Medical Research Radiological CenterRussian Federation20202406202072154163Copyright © Сидоров Д.В., Ложкин М.В., Петров Л.О., Исаева А.Г., Гусакова М.С., 20202020Сидоров Д.В., Ложкин М.В., Петров Л.О., Исаева А.Г., Гусакова М.С.Sidorov D.V., Lozhkin M.V., Petrov L.O., Isaeva A.G., Gusakova M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpmj.ru/rpmj/article/view/548

На сегодняшний день основной радикальный метод лечения больных гепатоцеллюлярной карциномой (ГЦК) — резекция печени. Кандидатами для хирургического лечения являются пациенты с сохранной функцией печени (Child-Pugh A класс), без поражения магистральных сосудов и отдаленных метастазов. Выполнение гемигепатэктомии сопряжено с высоким риском развития послеоперационной печеночной недостаточности при наличии таких отягчающих факторов, как портальная гипертензия, цирроз, тромбоз воротной вены, что приводит к преждевременному отказу от оперативного вмешательства. Современные рекомендации, основываясь на результатах рандомизированных исследований, для таких пациентов предлагают системную терапию, несмотря на отсутствие убедительных данных о ее эффективности в таких клинических ситуациях. Представленные наблюдения могут свидетельствовать об оправданности выбора расширенной гемигепатэктомии в качестве лечения гепатоцеллюлярного рака C стадии BCLC классификации.

Currently the main way of curable treatment of hepatocellular carcinomas (HCC)* is a liver resection. Candidates for surgery are patient with good score of liver function (Child-Pugh A group), without destruction of great vessels and distant metastases. Hemihepatectomy is associated with a high risk of postoperative liver failure (including portal hypertension, cirrhosis, portal vein thrombosis). This reason leads to premature failure of the operation. According to current clinical guidelines, system therapy is more suitable, despite of the lack of reliable data on its effectiveness in such clinical situations. The presented cases may support the selection of advanced hemihepatectomy as a treatment for hepatocellular cancer C stage BCLC classification.

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The authors declare that there are no conflicts of interest present.