Outcome of Liver Transplantation in Hepatocellular Carcinoma Patients at Siriraj Hospital
| Autor: | S. Limsrichamrern, S. Asavakarn, P. Kositamongkol, V. Sanphasitvong, Yongyut Sirivatanauksorn, Wethit Dumronggittigule, Prawej Mahawithitwong, Chutwichai Tovikkai, Ananya Pongpaibul |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Carcinoma Hepatocellular medicine.medical_treatment education 030230 surgery Milan criteria Liver transplantation 03 medical and health sciences 0302 clinical medicine Carcinoma medicine Humans In patient Survival rate Aged Retrospective Studies Transplantation business.industry Liver Neoplasms Retrospective cohort study Middle Aged Thailand medicine.disease Liver Transplantation Surgery Survival Rate Hepatocellular carcinoma Female 030211 gastroenterology & hepatology business Preoperative imaging |
| Zdroj: | Transplantation Proceedings. 49:1114-1117 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2017.03.047 |
| Popis: | Background Liver transplantation (LT) is one of the standard treatments for hepatocellular carcinoma (HCC), and the outcomes have become better after introduction of strict patient selection, such as the Milan criteria. However, several expanded criteria, such as the University of California San Francisco (UCSF) criteria, have demonstrated similar survival outcomes. The aim of this study was to verify survival outcomes of LT for HCC at Siriraj Hospital. Methods Sixty-three patients diagnosed with HCC who underwent cadaveric LT at Siriraj Hospital from 2002 to 2011 were included. All patients' characteristics, blood chemistries, size and number of tumors, bridging therapy, and survival and recurrence data were retrospectively reviewed and analyzed. Results Nearly all (62 patients, 98.4%) fulfilled the Milan criteria based on preoperative imaging. Explant pathology revealed that 40 patients (63.5%) were within Milan criteria and 50 patients (83%) within UCSF criteria. Demographic data, clinical laboratory, and bridging therapy were similar in patients within and outside both Milan and UCSF criteria. The 1-, 3-, and 5-year survival rates of patients within Milan were 85%, 75%, and 67.5%, and of those outside Milan were 69.6%, 52.2%, 52.2%, respectively (P = .25). Interestingly, with the use of the UCSF criteria, the 1-, 3-, and 5-year survival rates of patients within UCSF were significantly better than of those outside UCSF (84%, 76%, and 70% vs 61.5%, 30.8%, and 30.8%, respectively; P = .01). Conclusions Outcome of LT in HCC patients within Milan criteria demonstrated good long-term survival. However, providing the opportunity for HCC patients by expanding from Milan to UCSF criteria revealed similar outcomes. |
| Databáze: | OpenAIRE |
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