肝外复发性肝内胆管癌治疗决策进展  

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

作　　者：王一航 李江涛[1] WANG Yihang;LI Jiangtao(Department of Hepato-Biliary-Pancreatic Surgery,The Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院肝胆胰外科,杭州310009

出　　处：《临床肝胆病杂志》2024年第12期2361-2365,共5页Journal of Clinical Hepatology

基　　金：浙江省重点研发计划项目(2024C03172)。

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。There has been a constant increase in the incidence rate of intrahepatic cholangiocarcinoma in China,and as a highly fatal malignancy,it often has an extremely poor prognosis.Surgical resection is the only possible way to cure this disease,but postoperative recurrence rate reaches as high as 50%—70%.While recurrence is commonly observed in the liver,15%—30%of patients may experience extrahepatic recurrence.There are relatively few studies in the treatment strategies for extrahepatic recurrence,and there are still no clear guidelines for recommendation.Chemotherapy is currently the main treatment method for this disease.Studies have shown that some patients man achieve a prolonged survival time through surgical resection of extrahepatic recurrence sites,and in particular,such surgery is more feasible in patients with single focal lesion during recurrence.Nevertheless,surgery is only suitable to a small number of patients,and most patients still need to rely on systemic therapy and local treatment.Through a comprehensive analysis of related articles,this article summarizes the key influencing factors for extrahepatic recurrence,discusses the indications for surgery,and emphasizes the importance of individualized treatment strategies,in order to provide a reference for future treatment modalities.

关 键 词：胆管上皮癌 肿瘤复发 局部 治疗学 

分 类 号：R735.7[医药卫生—肿瘤]