肝移植治疗罕见肿瘤。

IF 1.8 4区 医学 Q3 TRANSPLANTATION Current Opinion in Organ Transplantation Pub Date : 2024-02-01 Epub Date: 2023-10-18 DOI:10.1097/MOT.0000000000001118
Andrew Melehy, Vatche Agopian
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引用次数: 0

摘要

综述目的:肝移植(LT)在治疗不可切除的肝细胞癌(HCC)方面的成功引起了人们对LT治疗其他肿瘤学疾病的兴趣。在此,我们讨论了LT在罕见肿瘤适应症中的作用,包括转移性胃肠胰神经内分泌肿瘤(GEP-NETs)、肝上皮样血管内皮瘤(HEHE)、纤维板层肝细胞癌(FLC)和肝血管肉瘤(HAS)。我们总结了LT治疗这些适应症的经验,并提出了管理指南。总结:如果使用严格的选择标准(低-中级,Ki-67%<20%,原发肿瘤完全切除,疾病稳定6个月,
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Treating rare tumors with liver transplantation.

Purpose of review: The success of liver transplantation (LT) in treating unresectable hepatocellular carcinoma (HCC) has resulted in interest in LT for other oncologic conditions. Here, we discuss the role of LT for rare oncologic indications including metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs), hepatic epitheliod hemangioendothelioma (HEHE), fibrolamellar hepatocellular carcinoma (FLC), and hepatic angiosarcoma (HAS).

Recent findings: Conditions reviewed have been documented indications for LT in the available literature. We summarize the experience of LT for these indications and proposed management guidelines.

Summary: GEP-NETs with isolated metastases to the liver can be treated with LT with excellent long-term outcomes (10-year survival 88%) if strict selection criteria are used (low-intermediate grade, Ki-67% < 20%, complete resection of primary tumor, stable disease for 6 months, <50% hepatic involvement). HEHE is a rare hepatic tumor for which LT can be performed with reported 10-year survival around 70%. FLC is a distinct clinical entity to HCC and is optimally treated with surgical resection though experience with LT is described in observational series (5-year survival 50%, recurrence in 10%). HAS is a rapidly progressive tumor with a dismal prognosis with or without treatment, including LT.

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来源期刊
CiteScore
4.10
自引率
4.50%
发文量
124
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.
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