适合移植的结直肠肝转移患者接受肝动脉输液治疗 - 一项回顾性队列研究
Pratik Chandra1, William Preston1, Rebecca Herbert1
1Department of Surgery, Hepatopancreatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Annals of surgery
|February 3, 2026
概括
不到5%的无法切除的结直肠肝转移 (CRLM) 患者满足了肝移植 (LT) 标准. 在肝动脉输液 (HAIP) 化疗后,5年生存率为53%,与最近的LT试验相比.
科学领域:
- 肝胆道手术 肝胆道手术
- 手术瘤学手术瘤学
- 医学瘤学 医学瘤学
背景情况:
- TransMet RCT显示,肝移植 (LT) 加上全身疗法改善了肝移植 (LT) 后的存活率,而非非切除性结直肠肝转移 (CRLM) 的单独全身疗法.
- 在将LT与其他治疗方法进行比较的试验中,全身疗法可能不是最佳的对照组.
- 本研究评估了用肝动脉输液 (HAIP) 化疗治疗的CRLM患者的结果,使用与TransMet试验类似的选择标准.
研究的目的:
- 确定可接受LT的不可切除的CRLM患者的比例.
- 为了评估这些接受HAIP化疗的患者的生存结果.
主要方法:
- 确定了2006-2016年期间接受HAIP化疗的不可切除的CRLM患者队列.
- 应用了修改后的TransMet/SECA-II选择标准,需要先进行一线化疗.
- 从HAIP安置时间开始,使用Kaplan-Meier方法计算了整体存活率 (OS) 和无进展存活率 (PFS).
主要成果:
- 在483名确定的患者中,23名 (4.8%) 符合LT资格标准.
- 18名患者 (78%) 在平均5个HAIP化疗周期后转换为切除.
- 平均生存期为61个月,五年生存期为53%. 中位数PFS为13个月.
结论:
- 在这个队列中,不到5%的不可切除的CRLM患者符合LT资格标准.
- 在符合LT条件的患者中,HAIP化疗导致5年后的生存率为53%.
- 这种生存率与最近一项LT随机试验中报告的5年生存率57%相比.
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