The presence of bilobar tumor should be considered as a new limit for transplantation beyond the Milan criteria?
| Autor: | Renato Ferrari Letrinta, Venâncio Avancini Ferreira Alves, Marcelo Augusto Fontenelle Ribeiro-Junior, Jorge Marcelo Padilla Mancero, Adriano Miziara Gonzalez, Luiz Augusto Carbeiro D´Albuquerque, Adávio de Oliveira e Silva, Francisco Leôncio Dazzi, Raul Carlos Wahle, Cristiane Maria de Freitas Ribeiro, Evandro Sobrosa Mello |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
Liver transplantation business.industry Proportional hazards model medicine.medical_treatment Carcinoma hepatocellular education Hazard ratio General Medicine Milan criteria medicine.disease Single Center Gastroenterology Surgery Transplantation Internal medicine Hepatocellular carcinoma medicine Risk factor business Transplante de fígado Carcinoma hepatocelular |
| Zdroj: | ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), Volume: 23, Issue: 1, Pages: 19-23, Published: MAR 2010 ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.23 n.1 2010 ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) Colégio Brasileiro de Cirurgia Digestiva (CBCD) instacron:CBCD |
| Popis: | BACKGROUND: An imprecise estimate of the tumor's aggressiveness of the hepatocellular carcinoma especially in transplanted patients beyond the Milan criteria has a poor outcome, although a more reliable criteria including microscopic vascular invasion is difficult to be established before transplantation. AIM: To examine a cohort of patients with hepatocellular carcinoma undergoing liver transplantation to evaluate the preoperative predicting factors for microscopic vascular invasion. METHODS: A series of 46 consecutive cirrhotic patients with hepatocellular carcinoma undergoing transplantation based on Milan criteria or similar criteria in a single center were enrolled between 1993 and 2007. The survival was calculated using Kaplan-Meyer's method and a multivariate Cox regression was performed to evaluate survival and factors related to microscopic vascular invasion. RESULTS: Multifocal tumors were present in 39%. Microvascular invasion, tumor relapses and hepatocellular carcinoma beyond the Milan criteria were identified in 33%, 13% and 33%, respectively. Overall 1-, 3-, and 5-year actuarial patient survival rates were 64%, 59% and 45% respectively. Patients who exceeded the Milan criteria had a higher incidence of microscopic vascular invasion and bilobar tumor compared to those who met the Milan criteria (53% vs. 23% and 80% vs. 19%; p |
| Databáze: | OpenAIRE |
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