肝切除或肝移植后肝癌患者肾上腺转移:来自三级转诊中心的经验。

IF 1.6 Q4 ONCOLOGY
International Journal of Surgical Oncology Pub Date : 2018-07-29 eCollection Date: 2018-01-01 DOI:10.1155/2018/4195076
Eva M Teegen, Martina T Mogl, Johann Pratschke, Nada Rayes
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引用次数: 15

摘要

摘要肝细胞癌(HCC)的肾上腺转移是一种罕见的疾病,可以通过切除、局部消融治疗或全身治疗来治疗。不幸的是,关于治疗结果的数据,尤其是肝移植接受者的数据,很少。患者与方法:2005年至2015年,我院共施行肝切除术990例,肝移植303例。我们回顾性分析HCC肾上腺异时性转移患者的治疗结果,这些患者接受切除、局部消融或仅监测。结果:共确诊10例(0.8%)。肝移植治疗原发性肝癌7例,肝切除术3例,局部消融治疗1例。8例患者行肾上腺切除术(1例经腹膜后镜检查),1例行局部消融治疗,1例仅进行监测。8例患者中有7例没有手术并发症,1例出现胰瘘,保守治疗。37.5%的患者在肾上腺切除术后1年复发率为37.5%,术后2年复发率为75%。原发性HCC的平均生存时间为96.6±22.4个月。肾上腺切除术后平均生存时间为112.4±25.2个月。总队列患者平均肿瘤复发时间为13.2±3.8个月,肾上腺切除术后患者平均肿瘤复发时间为15.8±3.8个月。肾上腺切除术后的总生存期为77.2±17.4个月。结论:发生异时性肾上腺转移的HCC患者不到1%。肾上腺切除术是一种安全的手术,即使在肝移植后也能获得可接受的存活率。因此,应在原发肿瘤控制良好,患者身体状况良好的情况下进行手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Adrenal Metastasis of Hepatocellular Carcinoma in Patients following Liver Resection or Liver Transplantation: Experience from a Tertiary Referral Center.

Adrenal Metastasis of Hepatocellular Carcinoma in Patients following Liver Resection or Liver Transplantation: Experience from a Tertiary Referral Center.

Adrenal Metastasis of Hepatocellular Carcinoma in Patients following Liver Resection or Liver Transplantation: Experience from a Tertiary Referral Center.

Introduction: Adrenal metastasis of hepatocellular carcinoma (HCC) is a rare entity and can be treated by resection, local ablative therapy, or systemic therapy. Unfortunately, data about treatment outcome, especially in liver transplant recipients, are rare.

Patients and methods: From 2005 to 2015, 990 liver resections and 303 liver transplantations because of HCC were performed at our clinic. We retrospectively analyzed treatment outcome of the patients with metachronous adrenal metastasis of HCC, who received either resection, local ablation, or surveillance only.

Results: 10 patients were identified (0.8%). 7 patients received liver transplantation for primary HCC therapy, 3 liver resection, and 1 a local ablative therapy. 8 patients underwent adrenalectomy (one via retroperitoneoscopy), one was treated with local ablation, and one had surveillance only. Seven out of eight patients had no surgical complications and one experienced a pancreatic fistula, treated conservatively. 37.5% of the resected patients had recurrence 1 year after adrenalectomy and 75% after 2 years. The mean survival time after primary diagnosis of HCC was 96.6±22.4 months. After adrenalectomy, the mean survival time was 112.4±25.2 months. The mean time until tumor recurrence was 13.2±3.8 in the total cohort and 15.8±3.8 months in patients after adrenalectomy. The estimated overall survival after adrenalectomy was 77.2±17.4 months.

Conclusion: Metachronous adrenal metastasis occured in less than 1% of HCC patients. Adrenalectomy is a safe procedure and leads to acceptable survival rates even after liver transplantion. Therefore, it should be performed whenever the primary tumor is well controlled and the patient is in adequate physical condition.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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