肝移植在肝门部胆管癌治疗中的应用
Liver transplantation in the management of perihilar cholangiocarcinoma.
作者信息
Gulamhusein Aliya F, Sanchez William
机构信息
Division of Gastroenterology & Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA.
出版信息
Hepat Oncol. 2015 Oct;2(4):409-421. doi: 10.2217/hep.15.30. Epub 2015 Nov 6.
Cholangiocarcinoma (CCA) is the second most common primary hepatic neoplasm and accounts for 10-20% of hepatobiliary cancer-related deaths. The prognosis of patients with CCA is poor with 5-year survival rates of 10%, partially due to the limited effective treatment options that exist for this disease. In this review, we discuss the evolving role of liver transplantation in the management of patients with perihilar CCA (pCCA). We specifically discuss the Mayo Clinic protocol of neoadjuvant chemoradiation followed by liver transplantation in selected patients with pCCA and describe pretransplant, peritransplant, and post-transplant considerations and challenges with this approach. Finally, we review local, national and international outcomes and discuss future directions in optimizing this treatment strategy for patients who otherwise have few therapeutic options and limited survival.
胆管癌（CCA）是第二常见的原发性肝脏肿瘤，占肝胆癌相关死亡病例的10%-20%。CCA患者的预后较差，5年生存率为10%，部分原因是针对该疾病的有效治疗选择有限。在本综述中，我们讨论了肝移植在肝门部胆管癌（pCCA）患者管理中的不断演变的作用。我们特别讨论了梅奥诊所对选定的pCCA患者采用新辅助放化疗后进行肝移植的方案，并描述了这种方法在移植前、移植中和移植后的注意事项及挑战。最后，我们回顾了本地、国家和国际上的治疗结果，并讨论了在优化这种治疗策略方面的未来方向，因为对于其他治疗选择很少且生存受限的患者来说，这一策略意义重大。
Zotero 插件