The treatment of primary liver cancer accompaning with lymph node metastasis is still one of the most challenge clinic task.It has similar prognosis with locally advanced hepatocellular carcinoma(IVA).The exact definition of regional lymph nodes related to liver is not provided in ready literatures.The clinical data of different lymph node metastasis is poor.The surgical treatment of liver cancer accompaning with lymph node metastasis is still controversial.Although survival time of some patients was able to benefit from resection without more mortality and modality,the prophylactic lymph node dissection may remove micrometastases of lymph nodes which can’t be detected through preoperative imaging examination.No critical tumor marker related to lymph node metastasis is found so far.The extent of regional lymphadenectomy to right lobe hepatic cancer should include hepatoduodenal ligament,peripancreatic,periportal,along the common hepatic artery and celiac lymph nodes.As to left lobe hepatic cancer,left gastric artery and omental sac lymph nodes should be dissected.The lymph node metastasis from liver cancer is sensitive to radiotherapy so the dose should be controlled within 56Gy.Radiofrequency ablation,local chemotherapy with percutaneous transhepatic lymphography and immunotherapy are some alternative therapies.
WANG Jian-dong
. Combined therapy of primary liver cancer with lymph node metastasis[J]. Surgical Research and New Technique, 2013
, 2(3)
: 145
-148
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DOI: 10.3969/j.issn.2095-378X.2013.03.003
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