肝内复发肝细胞癌的治疗选择：挽救性肝移植或再次肝切除术？

Options for the treatment of intrahepatic recurrent hepatocellular carcinoma: Salvage liver transplantation or rehepatectomy?

机构信息

Department of Hepatopancreatobiliary Surgery, Ningbo Medical Centre Lihuili Hospital, Medical School of Ningbo University, Zhejiang, China.

出版信息

Clin Transplant. 2020 May;34(5):e13831. doi: 10.1111/ctr.13831. Epub 2020 Mar 9.

DOI:10.1111/ctr.13831

PMID:32068916

Abstract

OBJECTIVE

To explore prognostic factors by comparing the efficacy of salvage liver transplantation (sLT) and rehepatectomy (RH) for the treatment of recurrent hepatocellular carcinoma after hepatectomy.

METHODS

Clinical data were collected for 124 patients treated at our center from January 2012 to August 2018. The median follow-up time for the patients was 39 months. By analyzing the clinical data between the sLT group (46 cases) and RH group (78 cases), the factors affecting the prognosis of patients were compared.

RESULTS

The proportion of alpha-fetoprotein (AFP) ≥ 100 µg/L in the recurrence group was significantly higher than that in the recurrence-free group (70.0% vs 22.2%, P = .014). The postoperative overall survival (OS) and recurrence-free survival (RFS) were better in the sLT group than in the RH group (81.2% vs 36.9%, P < .01; 77.1% vs 55.6%, P = .019). In the sLT group, the OS and RFS in the AFP < 100 µg/L group were superior to those in the AFP ≥ 100 µg/L group (P = .046 and P = .002).

CONCLUSION

The sLT group had achieved better efficacy than RH group, but when AFP ≥ 100 µg/L, sLT did not achieve better efficacy than RH.

摘要

目的

通过比较挽救性肝移植（sLT）和再次肝切除术（RH）治疗肝切除术后复发肝细胞癌的疗效，探讨预后因素。

方法

收集 2012 年 1 月至 2018 年 8 月我院治疗的 124 例患者的临床资料，中位随访时间为 39 个月。通过分析 sLT 组（46 例）和 RH 组（78 例）患者的临床资料，比较影响患者预后的因素。

结果

复发组甲胎蛋白（AFP）≥100μg/L 的比例明显高于无复发组（70.0%比 22.2%，P=0.014）。sLT 组患者的总生存（OS）和无复发生存（RFS）均优于 RH 组（81.2%比 36.9%，P<0.01；77.1%比 55.6%，P=0.019）。在 sLT 组中，AFP<100μg/L 组的 OS 和 RFS 优于 AFP≥100μg/L 组（P=0.046 和 P=0.002）。