Unit of HPB Surgery and Abdominal Organ Transplantation. "Doce de Octubre" University Hospital, Madrid, Spain.
Unit of HPB Surgery and Abdominal Organ Transplantation. "Doce de Octubre" University Hospital, Madrid, Spain.
Cir Esp (Engl Ed). 2023 Sep;101(9):624-631. doi: 10.1016/j.cireng.2023.04.010. Epub 2023 Apr 28.
The standard treatment for intrahepatic cholangiocarcinoma (iCCA) and mixed hepatocellular-cholangiocarcinoma (HCC-CC) is surgical resection, nevertheless, recent studies show adequate survival rates in selected patients with iCCA or HCC-CC undergoing liver transplantation (LT).
A retrospective cohort study was design including all patients undergoing LT at our center between January, 2006 and December, 2019 with incidentally diagnosed iCCA or HCC-CC after pathological examination of the explanted liver (n = 13).
There were no iCCA or HCC-CC recurrences during the follow-up, and hence, there were no tumor related deaths. Global and disease-free survival were the same. The 1, 3 and 5-years patient survival were 92.3%, 76.9% and 76.9%, respectively. Survival rates in the "early-stage tumor group" at 1, 3 and 5 years were 100%, 83.3% and 83.3%, respectively, with no significant differences as compared to the "advanced-stage tumors group". No statistically significant differences in terms of 5-year survival were found when comparing tumor histology (85.7% for iCCA and 66.7% for HCC-CC).
These results suggest that LT could be an option in patients with chronic liver disease who develop an iCCA or HCC-CC, even in highly selected advanced tumors, but we must be cautious when analyzing these results because of the small sample size of the series and its retrospective nature.
肝内胆管细胞癌(iCCA)和肝细胞癌-胆管细胞癌(HCC-CC)的标准治疗方法是手术切除,然而,最近的研究表明,在接受肝移植(LT)的选择患者中,iCCA 或 HCC-CC 具有足够的生存率。
本研究设计为回顾性队列研究,纳入 2006 年 1 月至 2019 年 12 月期间在我院接受 LT 的所有患者,术后对供肝进行病理检查,偶然诊断为 iCCA 或 HCC-CC(n=13)。
在随访期间未发生 iCCA 或 HCC-CC 复发,因此无肿瘤相关死亡。整体和无病生存率相同。1、3 和 5 年患者生存率分别为 92.3%、76.9%和 76.9%。1、3 和 5 年的“早期肿瘤组”生存率分别为 100%、83.3%和 83.3%,与“晚期肿瘤组”相比无显著差异。肿瘤组织学(iCCA 为 85.7%,HCC-CC 为 66.7%)之间的 5 年生存率无统计学差异。
这些结果表明,即使在高度选择的晚期肿瘤中,LT 也可能是患有慢性肝脏疾病并发生 iCCA 或 HCC-CC 的患者的一种选择,但由于该系列的样本量小且为回顾性研究,因此在分析这些结果时必须谨慎。