对于伴有具有临床意义的门静脉高压的肝细胞癌，热消融作为肝移植的替代方法：倾向评分匹配研究
Thermal ablation as an alternative to liver transplantation for hepatocellular carcinoma with clinically significant portal hypertension: propensity score matching study.
作者信息
Long Yinglin, Yang Zhou, Zeng Qingjing, Liu Zhongqi, Xu Erjiao, He Xuqi, Yuan Lianxiong, Fu Binsheng, Li Kai
机构信息
Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Hepatic Surgery and Liver Transplantation Center of the Third Affiliated Hospital, Organ Transplantation Institute, Sun Yat-sen University, Organ Transplantation, Research Center of Guangdong Province, Guangzhou, China.
出版信息
Front Oncol. 2023 Jun 26;13:1103347. doi: 10.3389/fonc.2023.1103347. eCollection 2023.
PURPOSE
The objectives were to investigate the safety and efficacy of thermal ablation as an alternative to liver transplantation for hepatocellular carcinoma patients with clinically significant portal hypertension (CSPH).
MATERIALS AND METHODS
From July 2016 to September 2019, hepatocellular carcinoma patients with CSPH treated by liver transplantation (N=37) or thermal ablation (N=114) were enrolled. Cumulative intrahepatic recurrence, overall survival and major complications were compared by propensity score matching.
RESULTS
In the two matched groups, the 1-, 2-, and 3-year intrahepatic recurrence rates for the ablation group (22.3%, 50.0%, and 50.0%, respectively) were significantly higher than those for the transplantation group (4.5%, 4.5%, and 4.5%, respectively) (P=0.016). The 1-, 2-, and 3-year overall survival rates were comparable between the two groups [96.1%, 88.7%, and 88.7%, respectively (ablation group) . 84.6%, 76.2%, and 76.2%, respectively (transplantation group)] (P=0.07). The major complication rate for the ablation group [4.8% (3/62)] was significantly lower than that for the transplantation group [36.0% (9/25)] (P<0.001).
CONCLUSIONS
Thermal ablation is a safe and effective alternative for hepatocellular carcinoma patients with CSPH.
目的
本研究旨在探讨热消融作为临床显著性门静脉高压（CSPH）肝细胞癌患者肝移植替代方案的安全性和有效性。
材料与方法
纳入2016年7月至2019年9月期间接受肝移植（N = 37）或热消融（N = 114）治疗的CSPH肝细胞癌患者。通过倾向评分匹配比较累积肝内复发率、总生存率和主要并发症。
结果
在两个匹配组中，消融组的1年、2年和3年肝内复发率（分别为22.3%、50.0%和50.0%）显著高于移植组（分别为4.5%、4.5%和4.5%）（P = 0.016）。两组的1年、2年和3年总生存率相当[消融组分别为96.1%、88.7%和88.7%；移植组分别为84.6%、76.2%和76.2%]（P = 0.07）。消融组的主要并发症发生率[4.8%（3/62）]显著低于移植组[36.0%（9/25）]（P<0.001）。
结论
热消融是CSPH肝细胞癌患者安全有效的替代方案。
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