Efficacy of liver transplantation for hepatic andhilar cholangiocarcinoma

Ensi Ma, Quan-bao Zhang, Yifeng Tao, Rui‐dong Li, Cong-huan Shen, Zhen-yu Ma, Jianhua Li, Yanting Jin
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Abstract

Objective To explore the clinical features and risk factors associated with intrahepatic and hilar cholangiocarcinoma after liver transplantation. Methods Retrospective analysis of clinical data was performed for 20 hospitalized patients with intrahepatic and hilar cholangiocarcinoma from June 25, 2014 to October 31, 2018. Treatments and follow-up outcomes were analyzed. The survival rate was calculated by the Kaplan-Meier method and the survival curve plotted. Cox regression model was employed for analyzing the prognostic factors. Results The cumulative recurrence rate of patients with AJCC stage Ⅰ /Ⅱ was significantly lower than that in AJCC stage Ⅲ/Ⅳ. And the cumulative recurrence rate of stage Ⅰ/Ⅱ Patients was 0 and that of stage Ⅲ/Ⅳ 76% (P=0.042). Cox regression model showed that CA19-9 was the only prognostic factor. An elevated level of CA19-9 was associated with high recurrence post-transplantation (HR=1.001; 95% CI: 1.000~1.001; P=0.035). Conclusions During progressive stage, the recurrence rate is higher with a worse prognosis. And an elevation of CA19-9 is an independent poor prognostic factor after intrahepatic and hilar cholangiocarcinoma transplantation. Key words: Liver transplantation; Cholangiocarcinoma; Relapse; Clinical staging
肝移植治疗肝门胆管癌的疗效观察
目的探讨肝移植术后肝内及肝门胆管癌的临床特点及相关危险因素。方法回顾性分析2014年6月25日至2018年10月31日住院的20例肝内及肝门胆管癌患者的临床资料。分析治疗方法及随访结果。采用Kaplan-Meier法计算存活率,绘制生存曲线。采用Cox回归模型分析影响预后的因素。结果AJCC期累积复发率Ⅰ/Ⅱ明显低于AJCC期Ⅲ/Ⅳ。累积复发率Ⅰ/Ⅱ期为0,Ⅲ/Ⅳ期为76% (P=0.042)。Cox回归模型显示CA19-9是唯一的预后因素。CA19-9水平升高与移植后高复发率相关(HR=1.001;95% ci: 1.000~1.001;P = 0.035)。结论进展期肿瘤复发率较高,预后较差。CA19-9的升高是肝内和肝门胆管癌移植后预后不良的独立因素。关键词:肝移植;胆管癌;复发;临床分期
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