Abstract:

Objective To summarize the therapeutic efficacy of liver transplantation in patients with intrahepatic cholangiocarcinoma（ICC）and to analyze the prognostic risk factors. Methods The clinicopathological data of 46 pathological confirmed ICC patients who underwent liver transplantation in Zhongshan Hospital Affiliated to Fudan University from April 2001 to February 2022 were analyzed retrospectively. The survival and recurrence of the patients were followed up. Kaplan Meier method was employed to analyze the overall survival（OS）rate and relapse-free survival（RFS） rate of patients，and Cox regression model was used to evaluate the risk factors affecting the prognosis. ResultsThe median overall survival time of patients with ICC after liver transplantation was 19 months，and the 1，3，5-year OS rates were 64.4%，30.2%，20.7%，respectively. The median RFS time was 10 months，and the 1，3 and 5-year RFS rates were 45.8%，20.8%，10.4%，respectively. The results of multivariate analysis revealed that the level of preoperative carbohydrate antigen19-9（CA19-9）（P ＝ 0.026）was an independent risk factor for the overall survival time of patients，and local extrahepatic structures due to direct ICC invasion（P ＝ 0.019）was an independent risk factor for tumor recurrence and metastasis. Conclusion The prognosis of liver transplantation for intrahepatic cholangiocarcinoma is poor. The high level of preoperative CA19-9 is an independent risk factor for short postoperative survival of recipients，and direct tumor invasion of extrahepatic tissues is an independent risk factor for high recurrence rate after liver transplantation. 

Key words:

 , Intrahepatic cholangiocarcinoma, Liver transplantation, Prognostic

摘要：

目的 总结肝内胆管癌患者进行肝移植的疗效和分析预后相关危险因素。方法 回顾性分析2001 年 4 月至 2022 年 2 月复旦大学附属中山医院 46 例病理诊断为肝内胆管癌的患者进行肝移植的临床病理资料，随访患者的生存、复发状况。采用 Kaplan-Meier 分析患者的总体生存率及无复发生存率，Cox 回归模型分析影响预后的危险因素。结果 肝内胆管癌患者肝移植术后中位总生存时间为 19 个月，1、3、5 年总生存率分别为 64.4%、30.2%、20.7%。中位无复发生存时间为 10 个月，1、3、5 年无复发生存率分别为45.8%、20.8%、10.4%。多因素分析结果显示，术前糖类抗原 19-9（carbohydrate antigen19-9，CA19-9）水平（P ＝ 0.026）是患者总生存时间的独立危险因素，肿瘤直接侵犯肝外组织（P＝0.019）是肿瘤复发转移的独立危险因素。结论 肝内胆管癌肝移植预后欠佳，术前CA19-9 高水平是术后生存期短、肿瘤直接侵犯肝外组织是术后复发率高的独立危险因素。 

关键词:

肝内胆管癌 , 肝移植 , 预后