Pattern and management of recurrent hepatocellular carcinoma after liver transplantation
| Autor: | Jorgelina Coppa, Vincenzo Mazzaferro, L. R. Fassati, Isabella Damilano, Andrea Pulvirenti, Enrico Regalia, Dardano G, Umberto Valente, F. Montalto |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Carcinoma Hepatocellular Adolescent medicine.medical_treatment Liver transplantation Milan criteria Gastroenterology Disease-Free Survival Recurrence Internal medicine medicine Humans Aged Neoplasm Staging Hepatology business.industry Liver Neoplasms Cancer Immunosuppression Middle Aged Prognosis medicine.disease Survival Analysis Recurrent Hepatocellular Carcinoma Liver Transplantation Transplantation Hepatocellular carcinoma Female Surgery Liver cancer business |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 0944-1166 |
| DOI: | 10.1007/pl00009947 |
| Popis: | A series of 132 patients who underwent liver transplantation for primary liver cancer was collected from three different Italian hospitals and studied for recurrence of hepatocellular carcinoma after liver replacement. Twenty-one patients (15.9%) had a neoplastic recurrence after an average follow-up period of 7.8 months after transplantation (range, 1–25 months); 15 (71%) occurred within the first 18 months after transplant and only two recurred later than 2 years. The sites of recurrence were grafted liver (19%), lung (19%), bone (14%), and other (5%). Eight patients (38%) had multiple organ involvement at the onset. After 1, 2, 3, and 4 years the overall survival rates were 62%, 43%, 29%, and 23%, respectively. The tumor factors related to early cancer recurrence after transplantation were diameter of nodules more than 3 cm (P < 0.05), tumor stage not meeting the "Milan criteria" (P < 0.03), and presence of peri-tumoral capsule (P < 0.05); the number of nodules, TNM stage, presence of vascular invasion, alpha-fetoprotein level more than 150 UI/l, pre-transplant chemoembolization and resectability of cancer deposits did not seem to be related to early recurrence. The prognosis differed in the 7 patients with resectable recurrences (57% 4-year survival) and the 14 patients with unresectable disease (14% 4-year survival) (P < 0.02). Better patient selection and new combined medical strategies could reduce the incidence of and mortality from liver cancer recurrence after transplantation. The role of surgical resection of recurrence should be further investigated. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink