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辅助化疗改善了肝细胞癌患者的移植后结果

Heng-Kai Zhu¹, Hai-Bo Mou², Zhuo-Yi Wang¹

¹Department of Hepatobiliary and Pancreatic Surgery, Key Laboratory of Artificial Organs and Computational Medicine in Zhejiang Province, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310000, China.

Hepatobiliary & pancreatic diseases international : HBPD INT

|June 17, 2025

概括

肝细胞癌 (HCC) 的肝移植 (LT) 后使用修改后的FOLFOX-6 (mFOLFOX-6) 的辅助化疗 (ACT) 减少了复发和死亡率. 这种治疗可能有利于LT后的高风险HCC患者.

科学领域:

肝病学肝病学是一种肝病学.
移植手术移植手术
医学瘤学医学瘤学

背景情况:

肝移植 (LT) 后肝细胞癌 (HCC) 复发是一个重大的临床挑战.
辅助化疗 (ACT) 正在探索,以改善后LT HCC患者的结果.

研究的目的:

评估辅助化疗 (ACT) 使用修改后的FOLFOX-6 (mFOLFOX-6) 疗法对肝细胞癌 (HCC) 复发和肝移植 (LT) 后死亡率的影响.

主要方法:

分析了2017年6月至2019年12月期间接受LT的HCC患者队列.
患者被分为ACT (n=57) 和非ACT (n=93) 组,随访时间中位数为54.0个月.
统计分析包括单变量/多变量考克斯模型,倾向得分调整/匹配和IPTW,以评估ACT对复发和死亡率的影响.

主要成果:

尽管ACT组的瘤特征较差 (大小,更多的瘤,MVI),但死亡风险明显较低 (HR=0.36,P=0.017).
敏感性分析证实了与ACT相关的死亡风险降低.
在M2级微血管侵袭的ACT患者中观察到更强的无复发生存益处 (相互作用的P=0.002).

结论:

使用mFOLFOX-6疗法进行辅助化疗 (ACT) 有效地降低了LT后HCC患者的复发和死亡风险.
对于在LT后存在高复发和死亡风险的HCC患者来说,ACT是一种潜在的治疗选择.

关键词:

辅助性化疗是一种辅助性化疗.阿尔法-胎儿蛋白是一种α-胎儿蛋白.肝细胞癌是肝细胞癌.肝移植肝移植肝移植微血管侵袭是一种微血管侵袭.

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