活体肝移植治疗不可切除肝门周围胆管癌的安全性和有效性:一项单中心前瞻性研究。

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Takashi Ito, Kojiro Taura, Ken Fukumitsu, Shinya Okumura, Satoshi Ogiso, Takayuki Anazawa, Kazuyuki Nagai, Yoichiro Uchida, Takamichi Ishii, Etsuro Hatano
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引用次数: 0

摘要

背景:不可切除的肝门周围胆管癌(phCCA)预后极差。肝移植联合新辅助放化疗已成为美国不可切除phCCA的治疗选择。2018年,我们开展了一项前瞻性研究,评估活体供肝移植(LDLT)治疗不可切除phCCA的安全性和有效性。方法:2018 - 2024年共纳入10例患者。最后,5例不可切除的phCCA患者在新辅助化疗、放疗和分期剖腹手术后接受了LDLT,而其他5例患者退出了治疗方案。结果:中位随访时间为23.7个月。5例接受LDLT治疗的患者在一年后的总生存率为100%。肝动脉血栓形成2例,胃排空延迟3例。根据Evans分类,所有5例患者术前治疗的组织学疗效均为IIb和III级。所有手术切缘及清扫淋巴结均为阴性。4例患者存活,无疾病复发迹象,1例患者在LDLT术后10个月复发。结论:LDLT是可行的,可能是不可切除的phCCA的最后治疗选择,尽管长期结果需要仔细监测。临床试验注册及临床注册号:本研究的UMIN注册号为000033348。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Safety and efficacy of living donor liver transplantation for unresectable perihilar cholangiocarcinoma: A single center prospective study

Safety and efficacy of living donor liver transplantation for unresectable perihilar cholangiocarcinoma: A single center prospective study

Background

The prognosis for unresectable perihilar cholangiocarcinoma (phCCA) is extremely poor. Liver transplantation in combination with neoadjuvant chemoradiation therapy has become the treatment of choice for unresectable phCCA in the USA. In 2018, we launched a prospective study to evaluate the safety and efficacy of living donor liver transplantation (LDLT) for unresectable phCCA.

Methods

A total of 10 patients were enrolled in this study between 2018 and 2024. Finally, five patients with unresectable phCCA underwent LDLT after neoadjuvant chemotherapy, radiation, and staging laparotomy, while the other five patients dropped out of the protocol.

Results

The median follow-up period was 23.7 months. The overall survival rate for the five patients who underwent LDLT was 100% after one year. Hepatic artery thrombosis and delayed gastric emptying occurred in two and three cases, respectively. The histological efficacy of preoperative treatment was grade IIb and III, according to the Evans classification, in all five patients. All surgical margins and dissected lymph nodes were negative. Four patients were alive with no evidence of disease recurrence while one patient had recurrence 10 months after LDLT.

Conclusions

LDLT is feasible and may be a last-resort treatment option for unresectable phCCA, although the long-term outcomes need to be carefully monitored.

Clinical trial register and clinical registration number

The UMIN registration number for this study is 000033348.

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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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