肝移植治疗无法切除的结直肠肝转移瘤。

IF 1.8 4区 医学 Q3 TRANSPLANTATION Current Opinion in Organ Transplantation Pub Date : 2023-08-01 Epub Date: 2023-06-19 DOI:10.1097/MOT.0000000000001083
Mariana Chávez-Villa, Luis I Ruffolo, Roberto Hernandez-Alejandro
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引用次数: 0

摘要

综述的目的:总结肝移植(LT)治疗不可切除结直肠肝转移瘤(uCRLM)的现状,并探讨未来的发展方向:挪威二次癌症(SECA)I和SECA II研究表明,经过高度筛选的uCRLM患者在肝移植后的5年生存率分别高达60%和83%。长期随访显示,5 年和 10 年生存率分别为 43% 和 26%。此外,其他国家也积累了相关数据,北美的一项研究报告显示,1.5 年存活率为 100%。此外,美国的数据也在稳步增长,迄今已有 46 名患者接受了移植手术,19 个中心也在为这一适应症招募患者。小结:越来越多的证据表明,经过严格筛选的尿道癌淋巴瘤患者可以获得极佳的生存率,甚至治愈,其生存率远高于接受化疗的患者。下一步是建立国家登记册,以统一选择标准,确定最佳方法和最佳实践,将LT治疗尿道癌纳入治疗手段。
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Liver transplantation for unresectable colorectal liver metastasis.

Purpose of review: To summarize the current state of liver transplantation (LT) for unresectable colorectal liver metastases (uCRLM), and to address future directions.

Recent findings: The Norwegian secondary cancer (SECA) I and SECA II studies demonstrated that after LT the 5-year survival of a highly selected group of patients with uCRLM could be as high as 60% and 83%, respectively. After long-term follow-up, the 5- and 10-year survival was shown to be 43% and 26%, respectively. Furthermore, data has accumulated in other countries and a North American study reported a 1.5-year survival of 100%. In addition, steady growth has been demonstrated in the US, with 46 patients transplanted to date and 19 centers enrolling patients for this indication. Lastly, although recurrence is almost universal in patients with a high tumor burden, it has not been an accurate surrogate for survival, reflecting the relatively indolent nature of recurrence after LT.

Summary: Growing evidence has shown that excellent survival and even cure can be achieved in highly selected patients with uCRLM, with survival rates far superior than in patients treated with chemotherapy. The next step is to create national registries to standardize selection criteria and establish the optimal approach and best practices for incorporating LT for uCRLM into the treatment armamentarium.

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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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