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肝移植用于结肠直肠癌的肝转移

Benjamin E Ueberroth¹, Michael Kriss², James R Burton²

¹Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, United States.

|January 21, 2025

概括

肝移植为患有结直肠癌肝转移的患者提供了生存益处. 仔细选择患者并遵守特定标准可以改善结果,使其成为晚期疾病的可行选择.

科学领域:

肝胆道手术肝胆道手术
手术瘤学手术瘤学
移植医学移植医学

背景情况:

肝移植已经显示出对结肠直肠癌 (CRC) 具有肝转移的生存益处.
器官保存方面的进步扩大了不可切除的肝转移的移植资格.
目前的数据表明,与普通肝移植接受者相比,整体存活率 (OS) 是可比的.

研究的目的:

评估肝移植对不可切割结直肠癌肝转移的疗效.
确定患者选择和改善结果的关键标准.
为了支持有关该患者群体器官分配的政策变化.

主要方法:

对临床试验和可用的关于CRC肝转移肝移植的文献的审查.
分析预测结果的因素,包括初级瘤切除,新辅助化疗和重新分期.
评估特定的标准,如癌胚抗原 (CEA) 水平和瘤大小.

主要成果:

改善的结果与R0切除,6-12个月的新辅助化疗,以及成像上阴性肝外疾病有关.
化疗反应预测了长期的结果;进展是一种禁忌.
CEA ≤80μg/L和最大瘤<5.5厘米与更好的无进展和OS相关.

结论:

肝移植与单独化疗相比,在精选的CRC肝转移患者中提供了优越的无进展和OS.
使用成像,实验室和临床数据进行严格的患者选择至关重要.
肝移植应考虑在高级CRC的活跃移植中心进行.

关键词:

化学疗法化疗化疗结肠癌是什么意思结肠癌是什么意思肝移植肝移植肝移植转移转移转移转移这是直肠癌.

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