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复发性肝内胆管细胞癌:多次肝切除术和射频消融的单中心经验。

Recurrent intrahepatic cholangiocarcinoma: single-center experience using repeated hepatectomy and radiofrequency ablation.

机构信息

Department of General, Visceral and Transplantation Surgery, Universitätsklinikum Charité, Campus Virchow Klinikum, Humboldt-Universität, Augustenburger Platz 1, 13353 Berlin, Germany.

出版信息

J Hepatobiliary Pancreat Sci. 2010 Jul;17(4):509-15. doi: 10.1007/s00534-009-0256-6. Epub 2010 Feb 3.

Abstract

BACKGROUND

Intrahepatic cholangiocarcinoma (IHC) is a rare liver malignancy with a rising incidence worldwide. Since no standard treatment has been established so far, the aim of this study was to assess the safety and efficacy of repeated liver resection and/or radiofrequency ablation (RFA) in selected cases with recurrent IHC.

PATIENTS AND METHODS

The outcome of 13 patients who had been treated at least once for recurrent IHC by repeated liver resection and/or RFA was retrospectively analyzed. A total of 12 repeated liver resections and 8 radiofrequency ablations were performed in these patients between 2002 and 2008.

RESULTS

After a median follow-up period of 28 months after primary liver resection (12-69 months), seven patients (54%) are still alive and three of these patients (23% of the entire cohort) are regarded as disease-free. The median survival for all patients was 51 months (12-69 months). One- and three-year survival after primary surgery was 92 and 52%, respectively, with an overall complication rate of 7.6%.

CONCLUSION

According to the present data, repeated liver resection and radiofrequency ablation are feasible in select patients with recurrent IHC. Both procedures can be regarded as safe and might lead to a prolongation of patient survival.

摘要

背景

肝内胆管细胞癌(IHC)是一种罕见的肝脏恶性肿瘤,全球发病率呈上升趋势。由于迄今为止尚未确立标准的治疗方法,本研究旨在评估在选定的复发性 IHC 病例中重复肝切除术和/或射频消融(RFA)的安全性和有效性。

患者和方法

回顾性分析了至少接受过一次重复肝切除术和/或 RFA 治疗复发性 IHC 的 13 例患者的结果。这些患者在 2002 年至 2008 年间共接受了 12 次重复肝切除术和 8 次射频消融术。

结果

在初次肝切除后中位随访时间为 28 个月(12-69 个月)后,7 例患者(54%)仍存活,其中 3 例(整个队列的 23%)无疾病。所有患者的中位生存期为 51 个月(12-69 个月)。初次手术后 1 年和 3 年的生存率分别为 92%和 52%,总体并发症发生率为 7.6%。

结论

根据目前的数据,重复肝切除术和射频消融术在选择的复发性 IHC 患者中是可行的。这两种方法都被认为是安全的,可能会延长患者的生存时间。

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