Liver transplantation (LT) in patients with hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) remains controversial. This study analyzed the recurrence and overall survival rates through long-term results after LT in HCC patients with BDTT and compared the results after LT in HCC patients with portal vein tumor thrombus (PVTT). We performed a retrospective study of 45 patients with PVTT, 16 patients with BDTT, and 11 patients with coexisting PVTT and BDTT among HCC patients who underwent LT at a single center from 1999 to 2020. The HCC recurrence rates were 40.4% at 1 year, 30.3.3% at 2 years, and 27.6% at 3 years in the PVTT group; 66.7%, 53.3%, and 46.7% in the BDTT group; and 22.2%, 22.2%, and 0% in the coexisting group (p= 0.183). Overall patient survival rates were 68.4% at 1 year, 54.3% at 2 years, and 41.7% at 3 years in the PVTT group; 81.3%, 62.5%, and 48.2% in the BDTT group; and 63.6%, 27.3%, and 0% in the coexisting group (p= 0.157). In the multivariate analysis, the pre-transplantation model for tumor recurrence after liver transplantation (MoRAL) score and model for end-stage liver disease (MELD) score were found to be independent risk factors for recurrence and survival in all groups. HCC patients with BDTT showed no difference in recurrence and survival compared with HCC patients with PVTT at the long-term follow-up after LT.
肝细胞癌合并胆管癌栓患者接受肝移植治疗仍存在争议。本研究通过长期随访数据分析此类患者的复发率与总生存率，并与合并门静脉癌栓的肝细胞癌肝移植患者进行对比。回顾性分析1999年至2020年间单中心接受肝移植的肝细胞癌患者，其中门静脉癌栓组45例，胆管癌栓组16例，双癌栓共存组11例。术后1年、2年、3年肝细胞癌复发率分别为：门静脉癌栓组40.4%、30.3%、27.6%；胆管癌栓组66.7%、53.3%、46.7%；双癌栓共存组22.2%、22.2%、0%（p=0.183）。患者总生存率分别为：门静脉癌栓组1年68.4%、2年54.3%、3年41.7%；胆管癌栓组81.3%、62.5%、48.2%；双癌栓共存组63.6%、27.3%、0%（p=0.157）。多因素分析显示，移植前肝移植肿瘤复发预测模型评分和终末期肝病模型评分是各组复发与生存的独立危险因素。长期随访结果显示，合并胆管癌栓的肝细胞癌患者肝移植后复发率与生存率与合并门静脉癌栓患者无显著差异。
肿瘤(癌症)患者之家