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对于不可切除的肝细胞癌进行转化疗法后的临床完整反应:是否需要救生性肝切除术?
Jia-Yi Wu1,2, Jun-Yi Wu1,2, De-Yi Liu1
1Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, People's Republic of China.
Journal of hepatocellular carcinoma
|December 11, 2023
概括
在无法切除的肝细胞癌 (uHCC) 患者中,在转化疗法后获得临床完整反应 (cCR) 的情况下,救生肝切除术可能不必. 生存结果显示,手术和非手术组之间没有显著差异.
科学领域:
- 肝胆道手术 肝胆道手术
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
背景情况:
- 不切除的肝细胞癌 (uHCC) 构成了重大的临床挑战.
- 转化疗法旨在将HHCC降低到潜在的治愈治疗.
- 在获得临床完整响应 (cCR) 的患者中,评估救援肝切除术至关重要.
研究的目的:
- 为了研究救援肝切除术在hhhCC患者的预后价值,在cCR转化后治疗.
- 为了比较手术和非手术管理之间的无疾病生存率 (DFS) 和整体生存率 (OS).
主要方法:
- 来自七个中国癌症中心的74名hhCC患者的cCR回顾性分析 (2018年10月至2021年12月).
- 一对一的倾向分数匹配 (PSM) 来控制混因素.
- 在救援肝切除术和非手术组之间比较DFS和OS率.
主要成果:
- 在PSM前后的手术和非手术组之间没有观察到DFS或OS的显著差异.
- 在PSM前:一年的DFS率为77.8% (手术) 与81.2% (非手术);一年的OS率为92.9%与100%.
- 后PSM:没有统计学上显著的生存益处救援肝切除术.
结论:
- 挽救性肝切除术可能不是HHCCCCCCCR患者的必要干预.
- 应考虑手术风险,特别是高风险患者.
- 需要进一步进行长期跟踪的前性研究.
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