肝内胆管细胞癌肝移植治疗的预后分析与策略选择

Prognosis analysis and strategies selection in liver transplantation for intrahepatic cholangio-carcinoma

  • 摘要: 肝内胆管细胞癌(ICC)是一种复杂的恶性肿瘤,预后差。早期,ICC患者肝移植后预后差,导致其曾一度被视为肝移植的禁忌证。但近年越来越多的研究对上述传统观点提出挑战,在合理选择受者或联合新辅助治疗条件下,肝移植在ICC患者中已取得较好预后。与手术切除等其他治疗措施比较,肝移植可改善ICC患者预后。与ICC肝移植预后相关的因素包括新辅助治疗、肿瘤整体负荷、肿瘤生物学行为以及移植后综合治疗措施等。基于目前临床研究,笔者针对ICC肝移植预后情况、ICC肝移植及其他治疗措施预后比较、ICC肝移植预后相关因素、ICC肝移植受者选择策略、ICC肝移植治疗的进步与挑战进行深入阐述。

     

    Abstract: Intrahepatic cholangiocarcinoma (ICC) is a complex malignant tumor with poor prognosis. Historically, the prognosis of ICC patients after liver transplantation is poor, which led to that it is once regarded as a contraindication of liver transplantation. However, in recent years, results of multiple studies challenge the above view. These emerging studies demonstrate that under the condition of reasonable selection of recipients or combined with neoadjuvant therapy, liver trans-plantation has achieved considerable prognosis in patients with ICC. In addition, compared with surgical resection and other treatments, liver transplantation can improve the prognosis of patients with ICC. The factors related to the prognosis of ICC patients who underwent liver transplantation include neoadjuvant therapy, overall tumor burden, tumor biological behavior and comprehensive treatment after transplantation, et al. Based on the results from currently existing clinical studies, the authors make a deep elaboration on the prognosis of ICC patients after liver transplantation, prognosis comparison between liver transplantation and other treatment measures for ICC, factors related to the prognosis of ICC patients who underwent liver transplantation, and the selection strategy of recipient of liver transplantation for ICC, and advance and challenge of liver transplantation for ICC.

     

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