结直肠癌肝转移肝移植后生存的性别差异:多变量分析
Alessandro Vitale1,2, Jacopo Lanari1,2, Umberto Cillo1,2
1Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy.
JHEP reports : innovation in hepatology
|September 11, 2025
概括
对结直肠肝转移的肝移植显示出有希望的生存率. 然而,女性的性别和特定的瘤特征与较差的结果有关,这挑战了这种先进癌症治疗的当前选择标准.
科学领域:
- 肝胆道手术 肝胆道手术
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 在TransMet试验之后,对于结直肠肝转移 (CRLMs) 的肝移植 (LT) 正在引起人们的兴趣.
- 目前缺乏在CRLM患者中对LT的多变量生存分析.
- 这项研究解决了在这种患者群体中需要可靠的生存数据的需求.
研究的目的:
- 在为CRLMs接受LT的多中心队列患者中进行多变量生存分析.
- 为了确定与CRLMs在LT后的生存结果相关的预后因素.
- 评估当前预后模型和选择标准的有效性.
主要方法:
- 对82名CRLM患者进行了LT (2006-2020年) 的回顾性多中心研究.
- 从七个美国和欧洲中心收集的数据.
- 分析采用多变量Cox和竞争风险模型,并进行了广泛的灵敏度分析.
主要成果:
- 一,三,五年的总生存率分别为93.7%,73.4%和54.9%.
- 与更高风险相关的因素包括女性性别,癌胚抗原>80μg/L,右侧CRC,最大直径>5.5厘米,KRAS突变和之前没有肝治疗.
- 其他具有更高不确定性的潜在关联包括pN2阳性CRC和>10个结节.
结论:
- 女性性别与CRLM的LT的较差结果有关.
- 目前在临床实践中使用的预后模型可能不够准确.
- 这些发现表明需要改进预后模型和修订CRLM患者中LT的选择标准.
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