作为桥梁治疗的预后指标的病理完整反应:对肝细胞癌和肝移植结果的25年回顾性研究
Cihan Agalar1, Tufan Egeli1, Mucahit Ozbilgin1
1Dokuz Eylul University School of Medicine, Department of General Surgery, Izmir, Turkey.
Transplantation proceedings
|August 31, 2025
概括
在肝移植 (LT) 之前,肝细胞癌 (HCC) 的过渡治疗没有改善结果. 然而,在治疗后实现病理完整反应 (CR) 显著预测了更好的生存率和LT后没有复发.
科学领域:
- 肝病学
- 癌症学
- 移植医学
背景情况:
- 肝细胞癌 (HCC) 是癌症死亡的主要原因.
- 肝移植 (LT) 是符合条件的HCC患者最有效的治疗方法.
- 桥梁疗法旨在控制移植等候名单中的瘤生长,但其预后价值仍有争议.
研究的目的:
- 评估桥梁疗法和病理完整反应 (CR) 对 HCC 的 LT 后结果的影响.
- 确定桥梁治疗是否影响移植后的生存率和复发率.
- 在接受LT的HCC患者中评估CR作为预后标志物.
主要方法:
- 在120名接受LT治疗的HCC患者 (1998-2023) 进行了回顾性分析.
- 在接受过桥疗法和不接受过桥疗法 (TACE,TARE,RFA,MWA) 的患者之间比较结果 (总生存率,无病生存率,复发率).
- 评估了病态CR的预后意义.
主要成果:
- 对24. 2%的患者进行过桥疗法;与没有过桥疗法相比,没有观察到OS或DFS的显著差异.
- 在27. 6%的桥梁患者中实现了病理性CR.
- 病理性CR与改善的生存状况 (P=0. 018) 和DFS (P=0. 05) 有关,CR患者没有复发或死亡.
结论:
- 单独的桥梁疗法对HCC患者的移植后生存没有独立的影响.
- 达到病理性完整反应是一个强有力的预测结果后,LT为HCC.
- 治疗反应,特别是CR,对于预测高血压患者的长期成功至关重要.
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