Treatment stage migration and treatment sequences in patients with hepatocellular carcinoma: drawbacks and opportunities.
Treatment stage migration and treatment sequences in patients with hepatocellular carcinoma: drawbacks and opportunities.
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肝细胞癌患者的治疗阶段迁移和治疗序列：缺点和机会。
DOI：
10.1007/s00432-021-03528-3
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发表时间：
2021-08
影响因子：
3.6
通讯作者：
Mieth M
中科院分区：
文献类型：
--
作者：
Wehling C;Dill MT;Olkus A;Springfeld C;Chang DH;Naumann P;Longerich T;Kratochwil C;Mehrabi A;Merle U;Pfeiffenberger J;Rupp C;Weiss KH;Mieth M
这项回顾性分析的重点是肝细胞癌（HCC）患者的治疗阶段迁移，以确定大型真实患者队列中的成功治疗序列。分析了1993年1月至2020年1月期间转诊至德国海德堡大学医院三级中心的1369例HCC患者的初始和后续治疗模式以及总生存期。最常见的初始治疗是经动脉化疗栓塞（TACE，n = 455，39.3%），随后行肝切除术（n = 303，26.1%）和全身治疗（n = 200，17.3%），而最常见的第二种治疗方式是肝移植（n = 215，33.2%），其次是全身治疗（n = 177，27.3%）和TACE（n = 85，13.1%）。Kaplan-Meier分析显示，肝移植受者的预后最好（中位总生存期未达到），其次是肝切除患者（11.1年）。接受系统治疗作为首次治疗的患者的中位总生存期最短（1.7年; P < 0.0001）。当肝移植前有三个或更多的治疗序列时，患者的中位总生存期显著缩短（第一个序列：未达到;第二个序列：12.4年;第3次连续：11.1超过3个序列：5.5年; P = 0.01）。TACE是最常见的初始干预，而肝移植是最常见的第二种治疗。虽然肝移植和肝切除与最佳中位总生存期相关，但治疗序列中肝移植的时机强烈影响中位生存期。在线版本包含补充材料，可通过10.1007/s 00432 -021-03528-3获得。
This retrospective analysis focuses on treatment stage migration in patients with hepatocellular carcinoma (HCC) to identify successful treatment sequences in a large cohort of real-world patients. 1369 HCC patients referred from January 1993 to January 2020 to the tertiary center of the Heidelberg University Hospital, Germany were analyzed for initial and subsequent treatment patterns, and overall survival. The most common initial treatment was transarterial chemoembolization (TACE, n = 455, 39.3%) followed by hepatic resection (n = 303, 26.1%) and systemic therapy (n = 200, 17.3%), whereas the most common 2nd treatment modality was liver transplantation (n = 215, 33.2%) followed by systemic therapy (n = 177, 27.3%) and TACE (n = 85, 13.1%). Kaplan–Meier analysis revealed by far the best prognosis for liver transplantation recipients (median overall survival not reached), followed by patients with hepatic resection (11.1 years). Patients receiving systemic therapy as their first treatment had the shortest median overall survival (1.7 years; P < 0.0001). When three or more treatment sequences preceded liver transplantation, patients had a significant shorter median overall survival (1st seq.: not reached; 2nd seq.: 12.4 years; 3rd seq.: 11.1 years; beyond 3 sequences: 5.5 years; P = 0.01). TACE was the most common initial intervention, whereas liver transplantation was the most frequent 2nd treatment. While liver transplantation and hepatic resection were associated with the best median overall survival, the timing of liver transplantation within the treatment sequence strongly affected median survival. The online version contains supplementary material available at 10.1007/s00432-021-03528-3.
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DOI：
10.1186/s13014-017-0818-8
发表时间：
2017-06-29
期刊：
Radiation oncology (London, England)
影响因子：
--
作者：
Mutsaers A;Greenspoon J;Walker-Dilks C;Swaminath A
通讯作者：
Swaminath A
影响因子：
7.6
作者：
Kirstein, Martha M.;Scheiner, Bernhard;Vogel, Arndt
通讯作者：
Vogel, Arndt
影响因子：
2.6
作者：
Akada, Keishi;Koyama, Noriyuki;Aoshima, Ken
通讯作者：
Aoshima, Ken
影响因子：
158.5
作者：
Finn, Richard S.;Qin, Shukui;Cheng, Ann-Lii
通讯作者：
Cheng, Ann-Lii
影响因子：
3.8
作者：
Nakano, Ryosuke;Ohira, Masahiro;Ohdan, Hideki
通讯作者：
Ohdan, Hideki