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偶然发现的胆管癌或肝细胞癌/胆管癌联合癌的肝移植——自身经验及文献综述

Liver Transplantation for Incidental Cholangiocarcinoma or Combined Hepatocellular Carcinoma/Cholangiocarcinoma-Own Experiences and Review of the Literature.

作者信息

Schwenk Laura, Rohland Oliver, Ali-Deeb Aladdin, Dondorf Felix, Settmacher Utz, Rauchfuß Falk

机构信息

Department of General, Visceral and Vascular Surgery, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany.

出版信息

Cancers (Basel). 2023 Jul 13;15(14):3609. doi: 10.3390/cancers15143609.

Abstract

BACKGROUND

Data about liver transplantation for mixed tumors from hepatocellular carcinoma to cholangiocarcinoma are limited. Furthermore, the diagnosis of intrahepatic cholangiocarcinoma or combined tumors in a cirrhotic liver is considered a contraindication for transplantation. Our aim was to evaluate the long-term outcomes of patients with incidental cholangiocarcinoma or combined tumors after liver transplantation.

METHODS

In our descriptive analysis, data were evaluated from all patients since 2010 who received a liver transplant due to an assumed hepatocellular carcinoma at Jena University Hospital. Survival rates were determined using the Kaplan-Meier method.

RESULTS

Between January 2010 and December 2022, an incidental intrahepatic cholangiocarcinoma was found in eight patients post-transplant. Four combined hepatocellular and cholangiocarcinoma and four sole intrahepatic cholangiocarcinomas were found. A recurrence through distant metastases from combined hepatocellular- and cholangiocarcinoma was found in one patient at one year after transplantation. Another patient developed a pulmonary primary tumor independently one year post-transplant. The recurrence rate was at 14.3%. While two patients died, the 1- and 5-year overall survival rates post-transplant were 87.5% and 75%, respectively.

CONCLUSION

Patients with intrahepatic cholangiocarcinoma or combined hepatocellular- and cholangiocarcinoma could profit from liver transplantation.

摘要

背景

关于肝细胞癌至胆管癌混合肿瘤肝移植的数据有限。此外,肝硬化肝脏中肝内胆管癌或合并肿瘤的诊断被认为是移植的禁忌症。我们的目的是评估肝移植后偶然发现胆管癌或合并肿瘤患者的长期预后。

方法

在我们的描述性分析中,评估了自2010年以来在耶拿大学医院因假定肝细胞癌接受肝移植的所有患者的数据。使用Kaplan-Meier方法确定生存率。

结果

2010年1月至2022年12月期间,移植后8例患者发现偶然的肝内胆管癌。发现4例肝细胞癌合并胆管癌,4例单纯肝内胆管癌。1例患者在移植后1年出现肝细胞癌合并胆管癌远处转移复发。另1例患者在移植后1年独立发生肺部原发性肿瘤。复发率为14.3%。2例患者死亡,移植后1年和5年总生存率分别为87.5%和75%。

结论

肝内胆管癌或肝细胞癌合并胆管癌患者可从肝移植中获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f1/10377009/a185534cda1d/cancers-15-03609-g001.jpg

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