Survival Benefit of Liver Transplantation Versus Resection for Hepatocellular Carcinoma: Impact of MELD Score
| Autor: | Matteo Cescon, Umberto Cillo, Anna Chiara Frigo, Alessandro Cucchetti, F. Tuci, T. Huo, Antonio Daniele Pinna, Alessandro Vitale, Michael L. Volk, Yun Hsuan Lee |
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| Přispěvatelé: | Vitale, Alessandro, Huo, Teh-La, Cucchetti, Alessandro, Lee, Yun-Hsuan, Volk, Michael, Frigo, Anna Chiara, Cescon, Matteo, Tuci, Francesco, Pinna, Antonio Daniele, Cillo, Umberto |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
Cirrhosis medicine.medical_treatment Liver transplantation Gastroenterology Model for End-Stage Liver Disease Risk Factors 80 and over Prospective Studies Child Aged 80 and over Relative survival Medicine (all) Liver Neoplasms Middle Aged Prognosis Survival Rate Oncology Liver Neoplasm Hepatocellular carcinoma Female Monte Carlo Method Human Adult medicine.medical_specialty Carcinoma Hepatocellular Adolescent Prognosi Follow-Up Studie Young Adult Internal medicine medicine Humans Hepatectomy Neoplasm Invasiveness Survival rate Aged Neoplasm Staging Neoplasm Invasivene business.industry Follow-Up Studies Liver Transplantation Surgery Risk Factor Carcinoma Hepatocellular medicine.disease Transplantation body regions Prospective Studie business |
| Popis: | Background: We sought to measure the impact of model for end stage liver disease (MELD) score, tumor staging, and microvascular invasion (MVI) on the relative survival benefit of liver transplantation (LT) versus liver resection (LR) for hepatocellular carcinoma (HCC).Results: Two hundred eighty-three patients (26 %) with a MELD score of ≥10 had an acceptable 5-year survival after LR of 47 %, while that of patients with a low MELD score was 67 % (p 10 cm) tumors, macrovascular invasion, and metastases. We identified three tumor stages: stage I (within Milan, n = 806), stage II (beyond Milan within Up-to-7, n = 123), and stage III (beyond Milan and Up-to-7, n = 177). Patient survival after LR was compared to that predicted after LT by the Metroticket calculator in relationship with staging, MVI, and MELD score using Monte Carlo simulation.Conclusions: LT proved to be harmful in patients with resectable HCC with a low MELD score ( |
| Databáze: | OpenAIRE |
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