■接受肝细胞癌(HCC)移植的患者中胆管肿瘤相关血栓的重要性存在争议。因此,我们对文献进行了系统回顾,并进行了汇总分析,以研究胆道侵袭对HCC复发和患者生存率的影响.
■筛选的1,584个参考文献中,其中8人用于分析。人口统计,患者和肿瘤因素,复发,并对生存数据进行分析。通过交叉参考生存曲线从每篇论文中提取复发和死亡的时间。
■在获得随访数据后,共纳入8项研究的35名患者进行分析。在1年,92.9%的肝癌合并胆管血栓移植患者存活。3年和5年的总生存率分别为65.5%和49.6%,分别。在1年,21.6%的患者病情复发,在3岁的时候,50.4%的患者复发。在第一年复发的患者中,71.4%在移植后的前3个月内复发。
■在最初5年内,患者总生存率下降,但后来稳定下来了.在此汇总分析中,49.6%的5年生存率低于米兰标准(50-78%)或最近报告的门静脉受累患者(63.6%)接受HCC移植的患者。尽管数据有限,但在这个未被研究的人群中缺乏长期随访。肝癌患者胆管受累的移植可能是一种可行的治疗选择,保证进一步调查。
UNASSIGNED: The significance of bile duct tumor-associated thrombi in patients undergoing transplantation for hepatocellular carcinoma (HCC) is controversial. Therefore, we performed a systematic review of the literature with pooled analysis to investigate the impact of biliary invasion on HCC recurrence and patient survival.
UNASSIGNED: Of 1,584 references screened, eight were included for analysis. Demographics, patient and tumor factors, recurrence, and survival data were analyzed. Time to recurrence and death were extracted from each paper by cross-referencing survival curves.
UNASSIGNED: A total of 35 patients across eight studies were pooled for analysis when follow-up data were available. At 1 year, 92.9% of patients undergoing transplantation for HCC with bile duct thrombi were alive. Overall survival at 3 and 5 years was 65.5 and 49.6%, respectively. At 1 year, 21.6% of patients had recurrence of their disease, while at 3 years, 50.4% of patients had recurrence. Of those patients with recurrence in the first year, 71.4% recurred within the first 3 months after transplantation.
UNASSIGNED: Overall patient survival decreased within the first 5 years, but then stabilized. The 5-year survival rate of 49.6% in this pooled analysis is lower than that reported for patients undergoing transplantation for HCC within the Milan criteria (50-78%) or recent reports in patients with portal vein involvement (63.6%), though data is limited by a lack of long-term follow-up in this understudied population. Transplantation for patients with HCC with bile duct involvement may be a viable treatment option, warranting further investigation.