Maspero Marianna, Sposito Carlo, Mazzaferro Vincenzo, Ercolani Giorgio, Cucchetti Alessandro
HPB and Liver Transplantation Unit, Fondazione, IRCCS Istituto Nazionale Tumori, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy.
Department of Medical and Surgical Sciences - DIMEC, Alma Mater Studiorum - University of Bologna, Bologna, Italy; Morgagni, Pierantoni Hospital, Forlì, Italy.
Dig Liver Dis. 2025 Jan;57(1):1-7. doi: 10.1016/j.dld.2024.06.021. Epub 2024 Jul 14.
Patients undergoing curative-intent surgery for hepato-pancreato-biliary (HPB) malignancies may achieve statistical cure i.e., a mortality risk which aligns with the general population.
To summarize the results of different cure models in HPB malignancies.
We conducted a systematic literature search and selected studies on curative-intent surgery (hepatic resection, HR, or liver transplantation, LT) for HPB malignancies including a cure model in their analysis. The review protocol was registered in PROSPERO (CRD42024528694).
Eleven studies reporting a cure model after HPB surgery for malignancy were included: 6 on hepatocellular carcinoma (HCC) two on biliary tract cancers (BTC), one on pancreatic neuroendocrine tumors (pNET), one on pancreatic ductal adenocarcinoma (PDAC), and one on colorectal liver metastases (CRLM). In terms of OS, the cure fraction of HCC is 63.4 %-75.8 % with LT and 31.8 %-40.5 % with HR, achieved within 7.2-10 years and 7-14.4 years respectively. The cure fraction of intrahepatic cholangiocarcinoma is 9.7 % in terms of DFS, but largely depends on tumor stage. PDAC and pNET display a cure fraction of 20.4 % and 57.1 % respectively in terms of DFS, confirming the impact of histotype on DFS.
Statistical cure for hepato-pancreato-biliary cancers can be achieved with surgery. The probability of cure depends on the interplay between tumor stage and aggressiveness, effectiveness of the surgical treatment and persistence of chronic conditions after surgery.
接受肝胰胆（HPB）恶性肿瘤根治性手术的患者可能实现统计学意义上的治愈，即死亡风险与普通人群相当。
总结HPB恶性肿瘤不同治愈模型的结果。
我们进行了系统的文献检索，并选择了关于HPB恶性肿瘤根治性手术（肝切除术、HR，或肝移植、LT）的研究，这些研究在分析中包括治愈模型。该综述方案已在PROSPERO（CRD42024528694）注册。
纳入了11项报告HPB恶性肿瘤手术后治愈模型的研究：6项关于肝细胞癌（HCC），2项关于胆管癌（BTC），1项关于胰腺神经内分泌肿瘤（pNET），1项关于胰腺导管腺癌（PDAC），1项关于结直肠癌肝转移（CRLM）。在总生存期方面，HCC接受LT的治愈比例为63.4%-75.8%，接受HR的为31.8%-40.5%，分别在7.2-10年和7-14.4年内实现。肝内胆管癌的无病生存期治愈比例为9.7%，但很大程度上取决于肿瘤分期。PDAC和pNET的无病生存期治愈比例分别为20.4%和57.1%，证实了组织学类型对无病生存期的影响。
通过手术可实现肝胰胆癌症的统计学治愈。治愈的可能性取决于肿瘤分期与侵袭性、手术治疗效果以及术后慢性病的持续情况之间的相互作用。
