伴有肝外胆管癌栓的肝细胞癌的手术治疗结果：一项多中心研究

Surgical outcomes of hepatocellular carcinoma with extrahepatic bile duct tumor thrombus: a multicenter study.

作者信息

Huang Li-Ming, Zeng Zhen-Xin, Wu Jun-Yi, Li Yi-Nan, Wang Jin-Xiu, Fu Yang-Kai, Wu Jia-Yi, Wei Shao-Ming, Lv Jia-Hui, Chen Wei-Zhao, Huang Rong-Fa, Cheng Shu-Qun, Yan Mao-Lin

机构信息

Shengli Clinical Medical College, Fujian Medical University, Fuzhou, Fujian, China.

Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, Fujian, China.

出版信息

Front Oncol. 2023 Dec 4;13:1291479. doi: 10.3389/fonc.2023.1291479. eCollection 2023.

DOI:10.3389/fonc.2023.1291479

PMID:38111530

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10726108/

Abstract

BACKGROUND

The long-term prognosis after surgery of patients with hepatocellular carcinoma (HCC) and extrahepatic bile duct tumor thrombus (Ex-BDTT) remains unknown. We aimed to identify the surgical outcomes of patients with HCC and Ex-BDTT.

METHODS

A total of 138 patients with Ex-BDTT who underwent hepatectomy with preservation of the extrahepatic bile duct from five large hospitals in China between January 2009 and December 2017 were included. The Cox proportional hazards model was used to analyze overall survival (OS) and recurrence-free survival (RFS).

RESULTS

With a median follow-up of 60 months (range, 1-127.8 months), the median OS and RFS of the patients were 28.6 and 8.9 months, respectively. The 1-, 3-, and 5-year OS rates of HCC patients with Ex-BDTT were 71.7%, 41.2%, and 33.5%, respectively, and the corresponding RFS rates were 43.5%, 21.7%, and 20.0%, respectively. Multivariate analysis identified that major hepatectomy, R0 resection, and major vascular invasion were independent prognostic factors for OS and RFS. In addition, preoperative serum total bilirubin ≥ 4.2 mg/dL was an independent prognostic factor for RFS.

CONCLUSION

Major hepatectomy with preservation of the extrahepatic bile duct can provide favorable long-term survival for HCC patients with Ex-BDTT.

摘要

背景

肝细胞癌（HCC）合并肝外胆管肿瘤血栓（Ex-BDTT）患者手术后的长期预后尚不清楚。我们旨在确定HCC合并Ex-BDTT患者的手术结局。

方法

纳入2009年1月至2017年12月间在中国五家大型医院接受保留肝外胆管肝切除术的138例Ex-BDTT患者。采用Cox比例风险模型分析总生存期（OS）和无复发生存期（RFS）。

结果

中位随访60个月（范围1-127.8个月），患者的中位OS和RFS分别为28.6个月和8.9个月。HCC合并Ex-BDTT患者的1年、3年和5年OS率分别为71.7%、41.2%和33.5%，相应的RFS率分别为43.5%、21.7%和20.0%。多因素分析确定，扩大肝切除术、R0切除和主要血管侵犯是OS和RFS的独立预后因素。此外，术前血清总胆红素≥4.2mg/dL是RFS的独立预后因素。