Impact of multiple liver resections prior to salvage liver transplantation on survival in patients with recurrent HCC.
Impact of multiple liver resections prior to salvage liver transplantation on survival in patients with recurrent HCC.
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挽救性肝移植前多次肝切除对复发性 HCC 患者生存的影响
DOI：
10.1136/bmjopen-2015-008429
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发表时间：
2015-09-09
期刊：
影响因子：
2.9
通讯作者：
Zheng S
中科院分区：
文献类型：
--
作者：
Hu Z;Zhang Q;Zhou J;Li Z;Xiang J;Zhou L;Wu J;Zhang M;Zheng S
挽救性肝移植（SLT）是一项有争议的技术，据报道它可用于治疗原发性肝切除（HR）后复发的肝细胞癌（HCC）患者。然而，肝切除的次数是否对SLT后的生存有影响尚未见报道。
回顾性研究。
医疗水平为初级，且该研究仅在一个中心进行。
该研究纳入了2001年9月至2012年12月期间因HCC接受SLT的59例患者。51例患者在SLT前仅接受过一次HR，而其余8例患者在SLT前接受过不止一次HR（HR = 2次[7例]，HR = 3次[1例]）。
在本研究中，比较了两组之间1年、3年和5年的总体生存率及无瘤生存率。
在接受SLT后，接受一次HR的患者与接受多次HR的患者在总体生存率或无瘤生存率方面没有显著差异。接受一次HR的患者1年、3年和5年总体生存率分别为72.9%、35.3%和35.5%，而接受多次HR的患者分别为50%、50%和50%（p = 0.986）；接受一次HR的患者1年、3年和5年无瘤生存率分别为66.3%、55.3%和44.4%，而接受多次HR的患者分别为40%、40%和40%（p = 0.790）。
在SLT前接受一次HR的患者与接受多次HR的患者生存率没有显著差异。这表明SLT对于HR后HCC复发的患者是一个合理的选择。
这是一项回顾性研究，不需要注册或编号。
Objectives Salvage liver transplantation (SLT) is a controversial technique that has been reported to be acceptable for the management of patients with recurrent hepatocellular carcinoma (HCC) after primary hepatic resection (HR). However, whether the number of times liver resection is performed has an impact on survival after SLT has not yet been reported. Design Retrospective study. Setting The level of care is primary and the study was carried out at only 1 centre. Participants The study included 59 patients who underwent SLT for HCC from September 2001 to December 2012. 51 patients underwent HR only once before SLT, while the remaining 8 patients underwent HR more than once before SLT (HR=2 [7], HR=3, [1]). Primary and secondary outcome measures In this study, the 1-year, 3-year and 5-year overall and tumour-free survival outcomes between the 2 groups were compared. Results There were no significant differences between patients who underwent HR once and those who underwent HR more than once with respect to overall or tumour-free survival after receiving SLT. The 1-year, 3-year and 5-year overall survival rates for patients who underwent HR once were 72.9%, 35.3% and 35.5% vs 50%, 50% and 50%, respectively (p=0.986), while the 1-year, 3-year and 5-year tumour-free survival rates for those who underwent HR more than once were 66.3%, 55.3% and 44.4% vs 40%, 40% and 40%, respectively (p=0.790). Conclusions There was no significant difference in the survival rate of patients who underwent HR once before SLT and those who underwent HR more than once. This suggests that SLT is a reasonable choice for patients who suffer from recurrent HCC after HR. Trial registration number This is a retrospective study and no registry or number is required.