Liver transplantation for combined hepatocellular-cholangiocarcinoma: Outcomes and prognostic factors for mortality. A multicenter analysis
Liver transplantation for combined hepatocellular-cholangiocarcinoma: Outcomes and prognostic factors for mortality. A multicenter analysis
复制标题
DOI：
10.1111/ctr.14094
复制
发表时间：
2021-01-15
影响因子：
2.1
通讯作者：
Oezcelik, Arzu
中科院分区：
文献类型：
--
作者：
Jaradat, Derar;Bagias, Georgios;Oezcelik, Arzu
简介：肝细胞-胆管细胞联合癌是一种罕见的肿瘤，它具有肝细胞癌和胆管细胞癌的特征。治疗的选择尚未确定。本研究的目的是分析肝细胞-胆管细胞癌联合患者接受肝移植后的结局。材料和方法：收集2001年1月至2018年8月期间接受肝移植的所有肝细胞-胆管细胞癌联合患者。回顾性评估术前、术中和术后数据。进行单因素分析，以确定预后因素。结果：共19例患者被纳入这项研究。围手术期死亡2例（10.5%）。11例患者（64.7%）在中位时间4个月内报告了疾病复发。1年和3年生存率分别为57.1%（CI 0.301-1）和38.1%（CI 0.137-1）。与死亡率相关的因素是肿瘤大小>3 cm、淋巴管浸润和ICU住院时间延长。混合型HCC-CC病变患者的生存率明显高于单肝HCC和CCC病变患者（p = .025）。结论：尽管与HCC患者相比，总生存率明显降低，但对于早期和真实的混合型HCC-CC患者，应考虑肝移植，这些患者可能从肝移植中获益。
Introduction: Combined hepatocellular-cholangiocarcinoma is rare and comprises features of hepatocellular carcinoma and cholangiocarcinoma. The treatment of choice has not yet been defined. The aim of the study was to analyze outcomes of patients with combined hepatocellular-cholangiocarcinoma, who underwent liver transplantation.Material and Methods: All patients with combined hepatocellular-cholangiocarcinoma, who underwent liver transplantation, from January 2001 to August 2018 were identified. Pre-, intra- and postoperative data were retrospectively assessed. A univariate analysis was performed to identify prognostic factors.Results: A total number of 19 patients were included to this study. Perioperative death was seen in two patients (10.5%). Recurrent disease was reported in 11 patients (64.7%) within the median time of 4 months. One and three years survival rates were 57.1% (CI 0.301-1) and 38.1% (CI 0.137-1). Factors associated mortality were tumor size >3 cm, presence of lymphatic invasion, and prolonged ICU stay. Patients with mixed HCC-CC lesions have significantly better survival compared to patients with separate lesions of HCC and CCC in one liver (p = .025).Conclusion: Although overall survival rates are clearly decreased compared to HCC patients, liver transplantation should be taken under consideration for selected patients with early stage and real mixed HCC-CC, who are likely to benefit from liver transplantation.