hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2019465-73hepato-438Research ArticleПЕЧЕНЬLIVERМеждисциплинарный подход в лечении пациентов с прогрессированием гепатоцеллюлярной карциномы после трансплантации печени: первый опыт в РоссииMultidisciplinary approach in hepatocellular carcinoma progression treatment after liver transplantation: the first experience in Russiahttps://orcid.org/0000-0002-0691-5581ОлисовО. Д.OlisovO. D.

канд. мед. наук, старший научный сотрудник отделения трансплантации печени 

129090, Москва, Большая Сухаревская площадь, д. 3, Российская Федерация 

Тел.: 8-495-628-35-02

Cand. of Sci. (Med.), Senior Researcher of the Department of Liver Transplant

3, Bolshaya Suharevskaya, Moscow, 129090, Russian Federation

Phone: 8-495-628-35-02

dr.olisov@gmail.comhttps://orcid.org/0000-0002-6323-511XДжанянИ. А.DzhanyanI. A.

Oncologist of Chemotherapy Department No.1 

115478, Moscow, 23, Kashirskoye Highway, Russian Federation

i-dzhanyan@mail.ruhttps://orcid.org/0000-0002-6362-7914НоврузбековМ. С.NovruzbekovM. S.

Doct. of Sci. (Med.), Chief Research Fellow of the Department of Liver Transplant

3, Bolshaya Suharevskaya, Moscow, 129090, Russian Federation

N.m.s@bk.ruhttps://orcid.org/0000-0002-6244-4294БредерВ. В.BrederV. V.

Doct. of Sci. (Med.), Leading Researcher of Chemotherapy Department No.1

115478, Moscow, 23, Kashirskoye Highway, Russian Federation

vbreder@yandex.ruhttps://orcid.org/0000-0002-9319-4902ИльинскийМ. Е.IlinskiyM. E.

Cand. of Sci. (Med.), Research Fellow of Intensive Care Unit

3, Bolshaya Suharevskaya, Moscow, 129090, Russian Federation

https://orcid.org/0000-0002-2517-7537ЗиминаЛ. Н.ZiminaL. N.

Doct. of Sci. (Med.), Leading Researcher of Pathology Department 

3, Bolshaya Suharevskaya, Moscow, 129090, Russian Federation

https://orcid.org/0000-0002-6775-3678МорозЕ. А.MorozE. A.

Cand. of Sci. (Med.), Senior Researcher of Pathomorphology Department 

115478, Moscow, 23, Kashirskoye Highway, Russian Federation

Moroz-kate@yandex.ruhttps://orcid.org/0000-0003-4469-502XЛактионовК. К.LaktionovK. K.

доктор мед. наук, профессор, заведующий отделением химиотерапии №1 

115478, Москва, Каширское шоссе, д. 23, Российская Федерация 

Doct. of Sci. (Med.), Professor, Head of the Chemotherapy Department No.1

115478, Moscow, 23, Kashirskoye Highway, Russian Federation

lkoskos@mail.ruhttps://orcid.org/0000-0001-8650-0855ГуляевВ. А.GuliaevV. A.

доктор мед. наук, ведущий научный сотрудник отделения трансплантации почки и поджелудочной железы 

129090, Москва, Большая Сухаревская площадь, д. 3, Российская Федерация 

https://orcid.org/0000-0003-2305-4055ЛуцыкК. Н.LutsykK. N.

Cand. of Sci. (Med.), Head of Surgery Unit of the Liver Transplant Department 

3, Bolshaya Suharevskaya, Moscow, 129090, Russian Federation

S.urg@mail.ruhttps://orcid.org/0000-0002-5057-6628МагомедовК. М.MagomedovK. M.

Surgeon of the Liver Transplant Department 

3, Bolshaya Suharevskaya, Moscow, 129090, Russian Federation

kubay.agul@gmail.comГБУЗ города Москвы “Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения города Москвы”РоссияSklifosovsky Research Institute for Emergency MedicineRussian FederationФГБУ “НМИЦ онкологии им. Н.Н. Блохина” Минздрава РоссииРоссияBlokhin National Medical Research Center of OncologyRussian Federation2019031220192446573Copyright © Олисов О.Д., Джанян И.А., Новрузбеков М.С., Бредер В.В., Ильинский М.Е., Зимина Л.Н., Мороз Е.А., Лактионов К.К., Гуляев В.А., Луцык К.Н., Магомедов К.М., 20192019Олисов О.Д., Джанян И.А., Новрузбеков М.С., Бредер В.В., Ильинский М.Е., Зимина Л.Н., Мороз Е.А., Лактионов К.К., Гуляев В.А., Луцык К.Н., Магомедов К.М.Olisov O.D., Dzhanyan I.A., Novruzbekov M.S., Breder V.V., Ilinskiy M.E., Zimina L.N., Moroz E.A., Laktionov K.K., Guliaev V.A., Lutsyk K.N., Magomedov K.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/438

Цель.Улучшение результатов лечения пациентов с прогрессированием гепатоцеллюлярной карциномы после трансплантации печени.Материал и методы. Тридцать пациентов с посттрансплантационным прогрессированием гепатоцеллюлярной карциномы были ретроспективно распределены на две группы. В 1-ю группу включили 20 пациентов, которым оказывали специализированное хирургическое и химиотерапевтическое лечение, во 2-ю – 10 больных, которым в связи с “запущенностью” онкологического заболевания проводили паллиативное и симптоматическое лечение.Результаты. Частота прогрессирования гепатоцеллюлярной карциномы была в 10 раз больше у пациентов, выходящих за пределы Миланских критериев: 57,8 и 5,7% соответственно. Раннее прогрессирование (в течение 24 мес) после трансплантации печени выявлено у 19 (63,3%) пациентов. Медиана общей выживаемости пациентов с ранним и поздним прогрессированием составила соответственно 17 и 74 мес. Полиорганное поражение обнаружено у 40% больных. Однолетняя, трех- и пятилетняя общая выживаемость пациентов 1-й и 2-й групп составила соответственно 90, 71, 50 и 30% и 0%. Медиана общей выживаемости больных 1-й и 2-й групп составила 37,8 и 12 мес.Заключение. Объем опухолевого поражения является определяющим фактором риска прогрессирования гепатоцеллюлярного рака после трансплантации печени. Позднее прогрессирование характеризуется лучшим прогнозом выживаемости. Мультидисциплинарный подход при прогрессировании гепатоцеллюлярной карциномы достоверно улучшает результаты лечения и общую выживаемость.

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The authors declare that there are no conflicts of interest present.