单中心11例肝内胆管细胞癌肝移植疗效分析

Liver transplantation for intrahepatic cholangiocarcinoma in 11 cases

目的 评价肝内胆管细胞癌患者肝移植的疗效,并分析其预后因素.方法 回顾性分析中山大学附属第三医院2003年10月至2008年12月间11例肝内胆管细胞癌肝移植患者的临床资料,采用Kaplan-Meier生存率分析肝移植术后患者存活率及无瘤存活率. 结果 11例术后均得到随访,肝移植术后生存时间2.5～53个月,中位生存时间为9.0个月,其受者1、2、3、4年无瘤存活率分别为51.9%、51.9%、51.9%、51.9%,1、2、3、4年累积存活率分别为50.5%、50.5%、50.5%、50.5%.围手术期死亡率为0,肿瘤复发率45.5%,肿瘤复发患者存活2.5～lO个月（平均7.5个月）,无瘤生存1～8个月（平均3.8个月）.结论 肝内胆管细胞癌患者施行肝移植的预后不良,有淋巴结转移或门静脉侵犯或胆管侵犯者,应列为肝移植禁忌证.

Objective To evaluate the effect of liver transplantation（LT）on the prognosis in patients with intrahepatic cholangiocarcinoma（ICC）.Methods A retrospective analysis was performed on 11 consecutive patients with ICC who underwent LT between October 2003 and November 2008 at our institution.The overall and disease-free survival rates were calculated by the Kaplan-Mayer method.Results The median survival time Was 9.0 months（2.5-53 months）.The 1-,2-,3-and 4-year disease-free survival rate and overall survival rate of all the patients were 51.9%、51.9%、51.9%、51.9%and 50.5%、50.5%、50.5%、50.5%,respectively.The perioperative mortality and the recurrence rate were 0 and 43.5%,respectively.The survival rate and disease-free survival time of patients with recurrence were 2.5-10 months（mean 7.5 months）and 1-8 months（mean 3.8 months）.Conclusions The prognosis of LT for ICC is rather poor.ICC patients with lymph node metastasis.vascular or bile duct invasion is contraindicated for LT.