Retrospective comparative analyses of liver transplantation for intrahepatic cholangiocarcinoma and combined hepatocellular cholangiocarcinoma versus hepatocellular carcinoma in Brazil.

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-01-18 DOI:10.1016/j.hpb.2025.01.008

Iron P De Abreu Neto, Vincenzo Pugliese, Paulo C B Massarollo, Bárbara B Benini, Mirella M M Marta, Vanessa S Takenaka, Francisco Monteiro, João Luis E Pessoa, Raymundo S De Azevedo Neto, Adriano M Gonzalez

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引用次数: 0

Abstract

Background: Despite the growing interest in liver transplantation for cholangiocarcinomas (CCA), conclusive evidence is lacking. We sought to evaluate the outcomes of liver transplantation for intrahepatic cholangiocarcinoma in Brazil.

Methods: Retrospective database analysis of patients undergoing liver transplantation for hepatocellular carcinoma (HCC) within Milan criteria in São Paulo, Brazil. Anatomopathological examination of the explanted liver with the presence of intrahepatic cholangiocarcinoma (iCCA) or combined hepatocellular-cholangiocarcinoma (cHCC-CCA) comprised the study group (50 patients). They were compared to a 1:3 HCC-matched cohort.

Results: Study group had lower survival rates than HCC controls (survival at 1, 3, and 5 years, 70.0 %, 57.5 %, and 57.5 % versus 78.7 %, 71.4 %, and 66.6 %, p = 0.019). 5-year survival rates of the control group, cHCC-CCA, and iCCA group were 66.6 %, 59.6 %, and 50.0 % (p = 0.017). There was no statistically significant difference in survival for study group patients with tumors up to 3 cm compared to their controls (p = 0.086).

Discussion: Patients with CCA had worse outcomes after liver transplantation than those with HCC. Interesting results were found in the more individualized analyses, but because of the limited number of patients, caution should be taken when analyzing them.

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巴西肝内胆管癌和合并肝细胞胆管癌与肝细胞癌的肝移植回顾性比较分析。

背景：尽管肝移植治疗胆管癌（CCA）的兴趣越来越大，但缺乏确凿的证据。我们试图评估巴西肝内胆管癌肝移植的结果。方法：回顾性数据库分析在巴西圣保罗米兰标准内接受肝移植的肝细胞癌（HCC）患者。研究组为解剖病理检查伴有肝内胆管癌（iCCA）或肝细胞-胆管癌合并（cHCC-CCA）的离体肝脏（50例）。将他们与1:3 hcc匹配队列进行比较。结果：研究组的生存率低于HCC对照组（1年、3年和5年生存率分别为70.0%、57.5%和57.5%，而78.7%、71.4%和66.6%,p = 0.019）。对照组、cHCC-CCA组、iCCA组5年生存率分别为66.6%、59.6%、50.0% （p = 0.017）。与对照组相比，研究组肿瘤达3cm患者的生存率无统计学差异（p = 0.086）。讨论：CCA患者在肝移植后的预后比HCC患者差。在更个性化的分析中发现了有趣的结果，但由于患者数量有限，在分析时应谨慎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).