中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

肝外复发性肝内胆管癌治疗决策进展

王一航 李江涛

引用本文:
Citation:

肝外复发性肝内胆管癌治疗决策进展

DOI: 10.12449/JCH241204
基金项目: 

浙江省重点研发计划项目 (2024C03172)

利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:王一航负责设计论文框架,起草和修改论文;李江涛负责拟定写作思路,指导撰写文章并最后定稿。
详细信息
    通信作者:

    李江涛, zjulijiangtao@163.com (ORCID: 0000-0001-7538-2910)

Advances in treatment decision-making for extrahepatic recurrence of intrahepatic cholangiocarcinoma

Research funding: 

Key Research and Development Program of Zhejiang Province (2024C03172)

More Information
  • 摘要: 肝内胆管癌的发病率在我国逐年上升,且作为一种高度致命的恶性肿瘤,预后极差。手术切除虽是唯一可能治愈的方法,但术后复发率高达50%~70%。复发部位最多见于肝脏,但也有15%~30%的患者发生肝外复发。针对肝外复发的治疗策略研究较少,尚无明确指南推荐,目前治疗多以化疗为主。研究显示,部分患者通过肝外复发部位的手术切除可延长生存期,尤其是单灶性复发的患者更具手术适应证。然而,手术仅适用于少数患者,大多数仍需依赖系统治疗及局部治疗。本文对相关文献进行综合分析,汇总影响肝外复发的关键因素,探讨手术相关适应证,强调个体化治疗策略的重要性,以期为未来的治疗模式提供参考。

     

  • [1] XIE CB, SHI D, LIN HL, et al. Spatial patterns of gallbladder and biliary tract carcinoma in China from 1990 to 2019: An analysis at the provincial level[J]. Cureus, 2023, 15( 8): e42796. DOI: 10.7759/cureus.42796.
    [2] WU L, TSILIMIGRAS DI, PAREDES AZ, et al. Trends in the incidence, treatment and outcomes of patients with intrahepatic cholangiocarcinoma in the USA: Facility type is associated with margin status, use of lymphadenectomy and overall survival[J]. World J Surg, 2019, 43( 7): 1777- 1787. DOI: 10.1007/s00268-019-04966-4.
    [3] MORIS D, PALTA M, KIM C, et al. Advances in the treatment of intrahepatic cholangiocarcinoma: An overview of the current and future therapeutic landscape for clinicians[J]. CA Cancer J Clin, 2023, 73( 2): 198- 222. DOI: 10.3322/caac.21759.
    [4] RAZUMILAVA N, GORES GJ. Cholangiocarcinoma[J]. Lancet, 2014, 383( 9935): 2168- 2179. DOI: 10.1016/S0140-6736(13)61903-0.
    [5] GRAVELY AK, VIBERT E, SAPISOCHIN G. Surgical treatment of intrahepatic cholangiocarcinoma[J]. J Hepatol, 2022, 77( 3): 865- 867. DOI: 10.1016/j.jhep.2022.01.004.
    [6] MAZZAFERRO V, GORGEN A, ROAYAIE S, et al. Liver resection and transplantation for intrahepatic cholangiocarcinoma[J]. J Hepatol, 2020, 72( 2): 364- 377. DOI: 10.1016/j.jhep.2019.11.020.
    [7] MAVROS MN, ECONOMOPOULOS KP, ALEXIOU VG, et al. Treatment and prognosis for patients with intrahepatic cholangiocarcinoma: Systematic review and meta-analysis[J]. JAMA Surg, 2014, 149( 6): 565- 574. DOI: 10.1001/jamasurg.2013.5137.
    [8] TSILIMIGRAS DI, SAHARA K, WU L, et al. Very early recurrence after liver resection for intrahepatic cholangiocarcinoma: Considering alternative treatment approaches[J]. JAMA Surg, 2020, 155( 9): 823- 831. DOI: 10.1001/jamasurg.2020.1973.
    [9] SPOLVERATO G, KIM Y, ALEXANDRESCU S, et al. Management and outcomes of patients with recurrent intrahepatic cholangiocarcinoma following previous curative-intent surgical resection[J]. Ann Surg Oncol, 2016, 23( 1): 235- 243. DOI: 10.1245/s10434-015-4642-9.
    [10] VOGEL A, BRIDGEWATER J, EDELINE J, et al. Biliary tract cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up[J]. Ann Oncol, 2023, 34( 2): 127- 140. DOI: 10.1016/j.annonc.2022.10.506.
    [11] BENSON AB, D’ANGELICA MI, ABRAMS T, et al. NCCN Guidelines® Insights: Biliary tract cancers, version 2.2023[J]. J Natl Compr Canc Netw, 2023, 21( 7): 694- 704. DOI: 10.6004/jnccn.2023.0035.
    [12] BARTSCH F, EBERHARD J, RÜCKERT F, et al. Repeated resection for recurrent intrahepatic cholangiocarcinoma: A retrospective German multicentre study[J]. Liver Int, 2021, 41( 1): 180- 191. DOI: 10.1111/liv.14682.
    [13] RAMOUZ A, ALI-HASAN-AL-SAEGH S, SHAFIEI S, et al. Repeat liver resection for recurrent intrahepatic cholangiocarcinoma: Meta-analysis[J]. Br J Surg, 2022, 109( 7): 580- 587. DOI: 10.1093/bjs/znac075.
    [14] SI AF, LI J, XING XL, et al. Effectiveness of repeat hepatic resection for patients with recurrent intrahepatic cholangiocarcinoma: Factors associated with long-term outcomes[J]. Surgery, 2017, 161( 4): 897- 908. DOI: 10.1016/j.surg.2016.10.024.
    [15] YAMASHITA YI, SHIRABE K, BEPPU T, et al. Surgical management of recurrent intrahepatic cholangiocarcinoma: Predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi-institutional study by the Kyushu study group of liver surgery[J]. Ann Gastroenterol Surg, 2017, 1( 2): 136- 142. DOI: 10.1002/ags3.12018.
    [16] PAWLIK TM. ASO author reflections: Understanding recurrence patterns and time courses of intrahepatic cholangiocarcinoma after surgery helps in postoperative surveillance and treatment[J]. Ann Surg Oncol, 2019, 26( 8): 2558- 2559. DOI: 10.1245/s10434-019-07437-1.
    [17] BAGANTE F, MERATH K, SQUIRES MH, et al. The limitations of standard clinicopathologic features to accurately risk-stratify prognosis after resection of intrahepatic cholangiocarcinoma[J]. J Gastrointest Surg, 2018, 22( 3): 477- 485. DOI: 10.1007/s11605-018-3682-4.
    [18] ZHANG XF, BEAL EW, BAGANTE F, et al. Early versus late recurrence of intrahepatic cholangiocarcinoma after resection with curative intent[J]. Br J Surg, 2018, 105( 7): 848- 856. DOI: 10.1002/bjs.10676.
    [19] KOJIMA T, UMEDA Y, FUJI T, et al. Efficacy of surgical management for recurrent intrahepatic cholangiocarcinoma: A multi-institutional study by the Okayama study group of HBP surgery[J]. PLoS One, 2020, 15( 9): e0238392. DOI: 10.1371/journal.pone.0238392.
    [20] BEKKI Y, VON AHRENS D, TAKAHASHI H, et al. Recurrent intrahepatic cholangiocarcinoma-review[J]. Front Oncol, 2021, 11: 776863. DOI: 10.3389/fonc.2021.776863.
    [21] CHAN KM, TSAI CY, YEH CN, et al. Characterization of intrahepatic cholangiocarcinoma after curative resection: Outcome, prognostic factor, and recurrence[J]. BMC Gastroenterol, 2018, 18( 1): 180. DOI: 10.1186/s12876-018-0912-x.
    [22] WANG C, PANG S, SI-MA H, et al. Specific risk factors contributing to early and late recurrences of intrahepatic cholangiocarcinoma after curative resection[J]. World J Surg Oncol, 2019, 17( 1): 2. DOI: 10.1186/s12957-018-1540-1.
    [23] LIN QZ, LIU HZ, ZHOU WP, et al. Effect of postoperative adjuvant chemotherapy on prognosis of patients with intrahepatic cholangiocarcinoma: A multicenter retrospective study[J]. Chin J Surg, 2023, 61( 4): 305- 312. DOI: 10.3760/cma.j.cn112139-20230106-00010.

    林起柱, 刘红枝, 周伟平, 等. 术后辅助化疗对肝内胆管癌预后影响的多中心回顾性研究[J]. 中华外科杂志, 2023, 61( 4): 305- 312. DOI: 10.3760/cma.j.cn112139-20230106-00010.
    [24] ASAOKA T, KOBAYASHI S, HANAKI T, et al. Clinical significance of preoperative CA19-9 and lymph node metastasis in intrahepatic cholangiocarcinoma[J]. Surg Today, 2020, 50( 10): 1176- 1186. DOI: 10.1007/s00595-020-01992-x.
    [25] HU LS, WEISS M, POPESCU I, et al. Impact of microvascular invasion on clinical outcomes after curative-intent resection for intrahepatic cholangiocarcinoma[J]. J Surg Oncol, 2019, 119( 1): 21- 29. DOI: 10.1002/jso.25305.
    [26] ZHANG SJ, HU P, WANG N, et al. Thermal ablation versus repeated hepatic resection for recurrent intrahepatic cholangiocarcinoma[J]. Ann Surg Oncol, 2013, 20( 11): 3596- 3602. DOI: 10.1245/s10434-013-3035-1.
    [27] SOUCHE R, ADDEO P, OUSSOULTZOGLOU E, et al. First and repeat liver resection for primary and recurrent intrahepatic cholangiocarcinoma[J]. Am J Surg, 2016, 212( 2): 221- 229. DOI: 10.1016/j.amjsurg.2015.07.016.
    [28] LANGELLA S, RUSSOLILLO N, OSSOLA P, et al. Recurrence after curative resection for intrahepatic cholangiocarcinoma: How to predict the chance of repeat hepatectomy?[J]. J Clin Med, 2021, 10( 13): 2820. DOI: 10.3390/jcm10132820.
    [29] YOH T, HATANO E, SEO S, et al. Long-term survival of recurrent intrahepatic cholangiocarcinoma: The impact and selection of repeat surgery[J]. World J Surg, 2018, 42( 6): 1848- 1856. DOI: 10.1007/s00268-017-4387-7.
    [30] SAKATA J, NOMURA T, AONO T, et al. Oncological outcomes of surgery for recurrent biliary tract cancer: Who are the best candidates?[J]. HPB(Oxford), 2021, 23( 9): 1371- 1382. DOI: 10.1016/j.hpb.2021.01.007.
    [31] KITANO Y, YAMASHITA YI, NAKAGAWA S, et al. Effectiveness of surgery for recurrent cholangiocarcinoma: A single center experience and brief literature review[J]. Am J Surg, 2020, 219( 1): 175- 180. DOI: 10.1016/j.amjsurg.2019.02.015.
    [32] YOH T, HATANO E, NISHIO T, et al. Significant improvement in outcomes of patients with intrahepatic cholangiocarcinoma after surgery[J]. World J Surg, 2016, 40( 9): 2229- 2236. DOI: 10.1007/s00268-016-3583-1.
    [33] SUN W, DING XY, CHEN JL, et al. Clinical effect and safety of radiofrequency ablation combined with systemic chemotherapy in treatment of unresectable or postoperative recurrent intrahepatic cholangiocellular carcinoma[J]. J Clin Hepatol, 2018, 34( 8): 1717- 1722. DOI: 10.3969/j.issn.1001-5256.2018.08.025.

    孙巍, 丁晓燕, 陈京龙, 等. 射频消融联合系统化疗治疗不可切除或术后复发肝内胆管癌的效果和安全性[J]. 临床肝胆病杂志, 2018, 34( 8): 1717- 1722. DOI: 10.3969/j.issn.1001-5256.2018.08.025.
    [34] LIN JZ, YANG X, LONG JY, et al. Pembrolizumab combined with lenvatinib as non-first-line therapy in patients with refractory biliary tract carcinoma[J]. Hepatobiliary Surg Nutr, 2020, 9( 4): 414- 424. DOI: 10.21037/hbsn-20-338.
    [35] GOYAL L, MERIC-BERNSTAM F, HOLLEBECQUE A, et al. Updated results of the FOENIX-CCA2 trial: Efficacy and safety of futibatinib in intrahepatic cholangiocarcinoma(iCCA) harboring FGFR2 fusions/rearrangements[J]. J Clin Oncol, 2022, 40( 16_suppl): 4009. DOI: 10.1200/jco.2022.40.16_suppl.4009.
    [36] SUI MH, LI Y, WANG HG, et al. Two cases of intrahepatic cholangiocellular carcinoma with high insertion-deletion ratios that achieved a complete response following chemotherapy combined with PD-1 blockade[J]. J Immunother Cancer, 2019, 7( 1): 125. DOI: 10.1186/s40425-019-0596-y.
    [37] YU W, HU CX, SHUI YJ, et al. Failure patterns after curative resection for intrahepatic cholangiocarcinoma: Possible implications for postoperative radiotherapy[J]. BMC Cancer, 2019, 19( 1): 1108. DOI: 10.1186/s12885-019-6328-3.
    [38] JUNG DH, KIM MS, CHO CK, et al. Outcomes of stereotactic body radiotherapy for unresectable primary or recurrent cholangiocarcinoma[J]. Radiat Oncol J, 2014, 32( 3): 163- 169. DOI: 10.3857/roj.2014.32.3.163.
    [39] SMART AC, GOYAL L, HORICK N, et al. Hypofractionated radiation therapy for unresectable/locally recurrent intrahepatic cholangiocarcinoma[J]. Ann Surg Oncol, 2020, 27( 4): 1122- 1129. DOI: 10.1245/s10434-019-08142-9.
  • 加载中
计量
  • 文章访问数:  85
  • HTML全文浏览量:  2280
  • PDF下载量:  23
  • 被引次数: 0
出版历程
  • 收稿日期:  2024-10-15
  • 录用日期:  2024-11-14
  • 出版日期:  2024-12-25
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回