肝门周围胆管癌：来自英国全国CAPBIL研究的结果

IF 2.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-08-22 DOI:10.1016/j.hpb.2025.08.003

Jane McClements, Amanda Koh, Harivinthan Sellappan, Lauren Blackburn, Adam Brooks, Jake Clements, Nabeel Merali, Adam Frampton, Syeda Gulbahar, Brian Davidson, Eyas Almomani, David Bartlett, Georgios Papadopoulos, Dimitrios Karavias, Alistair Rowcroft, James Lucocq, Ewen M Harrison, Victoria Morrison-Jones, Fenella Welsh, Adithya Pathanki, Gabriele Marangoni, Paris Bruno, James Skipworth, Harry Spiers, Vasilis Kosmoliaptsis, Timothy Gilbert, Hassan Malik, Aarathi Vijayashanker, Krishna Menon, Waqqas Patel, Mohammed Bekheit, Lulu Tanno, Michael Silva, Christopher Brown, Nagappan Kumar, Joel Triance, Nehal Shah, Tareq Alsaoudi, Neil Bhardwaj, Hussein Nassar, Omar Mownah, Derek Yeung, Ricky Bhogal, Ruth Blanco-Colino, Shahid Farid, Rami Aljaberi, Sanjay Pandanaboyana, Omar Abdelmohsin, Somaiah Aroori, Daisy Evans, Tejinderjit Athwal, Peter Lodge, Dhanwant Gomez

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引用次数: 0

摘要

背景：肝移植作为可切除的肝门周围胆管癌（pCCA）的治疗选择是有争议的。本研究调查了英国早期pCCA切除术后的结果。方法：纳入了2014年至2022年间在英国22个中心接受pCCA切除术的患者。早期pCCA被定义为肿瘤大小。结果：在纳入的450例患者中，138例患者接受了早期pCCA切除术。在早期pCCA组，CD≥IIIa的发病率为39.1% (n = 54)， 90天死亡率为10.1% （n = 14）。64例（46.4%）患者接受了辅助化疗，但在CD≥IIIa的患者中，辅助化疗减少（n = 17, 31.5%）。早期肿瘤的血管侵袭（n = 57, 41.3%）和R1边缘（n = 46, 33.3%）明显低于晚期pCCA [62.2% （n = 194）和54.2% (n = 169), p < 0.001]。早期pCCA患者的中位无病生存期和总生存期明显优于晚期肿瘤患者（p < 0.001）。男性（p = 0.039）和肝切除术后肝功能衰竭（PHLF, p = 0.010）与较差的无病生存相关，而胆道引流（p = 0.013）、PHLF （p < 0.001）和血管侵犯（p = 0.030）与较差的总生存相关。结论：在集中的HPB中心，早期pCCA肿瘤切除与良好的临床和生存结果相关。

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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Peri-hilar cholangiocarcinoma: results from the UK nationwide CAPBIL study.

Background: The role of liver transplantation as a treatment option for de novo resectable peri-hilar cholangiocarcinoma (pCCA) is controversial. This study investigated the outcomes following resection of early-stage pCCA in the UK.

Methods: Patients undergoing resection for pCCA between 2014 and 2022 across 22 UK centres were included. Early-stage pCCA was defined as tumour size<3cm with no nodal disease (N0) on histopathology analysis. Clinical and survival data were collated.

Results: Of the 450 patients included, 138 patients underwent resection for early-stage pCCA. In the early-stage pCCA group, CD ≥ IIIa morbidity was 39.1 % (n = 54) and 90-day mortality was 10.1 % (n = 14). Sixty-four (46.4 %) patients received adjuvant chemotherapy, but this was reduced in those with CD ≥ IIIa morbidity (n = 17, 31.5 %). Early-stage tumours had a significantly lower vascular invasion (n = 57, 41.3 %) and R1 margin (n = 46, 33.3 %) compared to later-stage pCCA [62.2 % (n = 194) and 54.2 % (n = 169) respectively, p < 0.001). The median disease-free and overall survival was significantly better in patients with early-stage pCCA compared to more advanced tumours (p < 0.001). Male gender (p = 0.039) and Post-Hepatectomy Liver Failure (PHLF, p = 0.010) were associated with significantly worse disease-free survival, while biliary drainage (p = 0.013), PHLF (p < 0.001) and vascular invasion (p = 0.030) were associated with significantly poorer overall survival.

Conclusion: Resection of early-stage pCCA tumours is associated with good clinical and survival outcomes in centralised HPB centres.

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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).