肝细胞癌合并胆管癌与肝内胆管癌腹腔镜肝切除的围手术期及长期结局：一项倾向评分匹配分析
Perioperative and long-term outcomes of laparoscopic liver resection for combined hepatocellular carcinoma and cholangiocarcinoma versus intrahepatic cholangiocarcinoma: A propensity score matching analysis.
作者信息
Du Chengfei, Wang Hanyu, Cao Wenli, Yu Zichen, Liu Junwei, Liu Jie, Jin Liming, Feng Yunyun, Wei Fangqiang
机构信息
Department of General Surgery, Cancer center, Division of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang Province, China.
Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
出版信息
PLoS One. 2025 Aug 18;20(8):e0328104. doi: 10.1371/journal.pone.0328104. eCollection 2025.
BACKGROUND
Laparoscopic liver resection (LLR) has been increasingly used to treat intrahepatic cholangiocarcinoma (ICC), yet the role of LLR on combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) remains unclear. The purpose of this study was to compare the perioperative efficacy and long-term prognosis of LLR for cHCC-CC and ICC through the use of propensity score matching (PSM) analysis.
METHODS
Clinicopathologic, perioperative, and survival data of patients with cHCC-CC and ICC who underwent LLR from November 2018 to May 2023 at our institution were retrospectively collected. The two groups were further analyzed using 1:1 PSM to compare perioperative outcomes and long-term prognosis.
RESULTS
A total of 115 patients who underwent LLR for either eHCC-CC or ICC were ultimately included in the study. Among them, there were 24 cases in the cHCC-CC group and 91 cases in the ICC group. After PSM, the cHCC-CC group exhibited a significantly higher prevalence of preoperative elevated AFP levels (45.8% vs. 0, P < 0.001) compared with the ICC group. The two groups were comparable in terms of perioperative data. After a median follow-up of 34 months, there were no significant difference in 1-year OS (92% vs. 88%), 2-year OS (62% vs. 70%), 3-year OS (49% vs. 59%), 1-year RFS (46% vs. 58%), 2-year RFS (29% vs. 54%), 3-year RFS (29% vs. 42%) between the cHCC-CC and ICC groups (all P > 0.05).
CONCLUSIONS
The perioperative outcomes and long-term prognosis of LLR for patients with cHCC-CC are comparable to those observed in patients with ICC.
背景
腹腔镜肝切除术（LLR）已越来越多地用于治疗肝内胆管癌（ICC），然而LLR在肝细胞癌合并胆管癌（cHCC-CC）中的作用仍不清楚。本研究的目的是通过倾向评分匹配（PSM）分析比较LLR治疗cHCC-CC和ICC的围手术期疗效及长期预后。
方法
回顾性收集2018年11月至2023年5月在我院接受LLR的cHCC-CC和ICC患者的临床病理、围手术期及生存数据。采用1:1 PSM对两组进行进一步分析，以比较围手术期结局和长期预后。
结果
本研究最终纳入115例行LLR治疗eHCC-CC或ICC的患者。其中，cHCC-CC组24例，ICC组91例。PSM后，与ICC组相比，cHCC-CC组术前甲胎蛋白（AFP）水平升高的发生率显著更高（45.8% 对0，P < 0.001）。两组围手术期数据具有可比性。中位随访34个月后，cHCC-CC组和ICC组在1年总生存率（92% 对88%）、2年总生存率（62% 对70%）、3年总生存率（49% 对59%）、1年无复发生存率（46% 对58%）、2年无复发生存率（29% 对54%）、3年无复发生存率（29% 对42%）方面均无显著差异（所有P > 0.05）。
结论
cHCC-CC患者LLR的围手术期结局和长期预后与ICC患者相当。
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