LIVER TRANSPLANTATION FOR CARCINOMA HEPATOCELLULAR IN SÃO PAULO: 414 CASES BY THE MILAN/BRAZIL CRITERIA.

Autor:	Sá GP; Postgraduation Program in Interdisciplinary Surgical Science, Federal University of São Paulo, São Paulo, SP, Brazil., Vicentine FP; Postgraduation Program in Interdisciplinary Surgical Science, Federal University of São Paulo, São Paulo, SP, Brazil.; ; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil., Salzedas-Netto AA; Postgraduation Program in Interdisciplinary Surgical Science, Federal University of São Paulo, São Paulo, SP, Brazil.; ; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil., Matos CA; ; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil., Romero LR; ; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil., Tejada DF; ; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil., Massarollo PC; Sector of Liver Transplantation, Department of Surgery, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil., Lopes-Filho GJ; Postgraduation Program in Interdisciplinary Surgical Science, Federal University of São Paulo, São Paulo, SP, Brazil.; ; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil., Gonzalez AM; Postgraduation Program in Interdisciplinary Surgical Science, Federal University of São Paulo, São Paulo, SP, Brazil.; ; Sector of Liver Transplantation, Discipline of Surgical Gastroenterology, Federal University of São Paulo; São Paulo, SP, Brazil.
Jazyk:	English; Portuguese
Zdroj:	Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery [Arq Bras Cir Dig] 2016 Nov-Dec; Vol. 29 (4), pp. 240-245.
DOI:	10.1590/0102-6720201600040007
Abstrakt:	Background: The criterion of Milan (CM) has been used as standard for indication of liver transplantation (LTx) for hepatocellular carcinoma (HCC) worldwide for nearly 20 years. Several centers have adopted criteria expanded in order to increase the number of patients eligible to liver transplantation, while maintaining good survival rates. In Brazil, since 2006, the criterion of Milan/Brazil (CMB), which disregards nodules <2 cm, is adopted, including patients with a higher number of small nodules. Aim: To evaluate the outcome of liver transplantation within the CMB. Methods: The medical records of patients with HCC undergoing liver transplantation in relation to recurrence and survival by comparing CM and CMB, were analyzed. Results: 414 LTx for HCC, the survival at 1 and 5 years was 84.1 and 72.7%. Of these, 7% reached the CMB through downstaging, with survival at 1 and 5 years of 93.1 and 71.9%. The CMB patient group that exceeded the CM (8.6%) had a survival rate of 58.1% at five years. There was no statistical difference in survival between the groups CM, CMB and downstaging. Vascular invasion (p<0.001), higher nodule size (p=0.001) and number of nodules >2 cm (p=0.028) were associated with relapse. The age (p=0.001), female (p<0.001), real MELD (p<0.001), vascular invasion (p=0.045) and number of nodes >2 cm (p<0.014) were associated with worse survival. Conclusions: CMB increased by 8.6% indications of liver transplantation, and showed survival rates similar to CM. Competing Interests: none
Databáze:	MEDLINE
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