移植瘤学指示的演变:40多年的单一机构经验
Quirino Lai1, Simona Parisse2, Stefano Ginanni Corradini2
1General Surgery and Organ Transplantation Unit, Department of General and Specialty Surgery, Sapienza University of Rome, AOU Policlinico Umberto I of Rome, Rome, Italy. lai.quirino@libero.it.
Updates in surgery
|April 8, 2024
概括
对于罕见癌症的肝移植 (LT) 显示了不断变化的趋势和生存影响. 虽然过去的结果很差,但最近的数据显示出潜力,需要对这种肝移植瘤学方法进行仔细的患者选择.
科学领域:
- 肝胆道手术 肝胆道手术
- 移植瘤学 移植瘤学
- 胃肠病学 胃肠病学
背景情况:
- 对于不常见的瘤征兆来说,肝移植 (LT) 已经显著发展.
- 这些疾病的早期LT系列报告了糟糕的结果,通常是由于非瘤原因.
研究的目的:
- 为了分析一个单一中心对LT的经验,以寻找不常见的瘤迹象.
- 探索随着时间的推移对患者生存的进化和影响.
主要方法:
- 在1982年至2023年期间,对851个LT进行了回顾性分析.
- 鉴定和分类33例 (3.9%) 具有不常见的瘤迹象的病例.
主要成果:
- 不常见的征兆在1982-1989年间达到顶峰,在2000年后消失,最近略有增加.
- 观察到5年生存率较低:28.6% (非肝硬化肝脏上的HCC),25.0% (周围肝脏的CCA),0% (肝脏内CCA,转移).
- 患者的死亡经常归因于非瘤疾病.
结论:
- 在全球范围内,不常见的癌症疾病的LT正在增加.
- 虽然这些罕见瘤的历史LT结果很差,但最新的数据显示有希望.
- 移植决定需要仔细评估风险和益处;正在进行的研究可能会验证非常规的适应症.
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