Liver Transplantation for Hepatocellular Carcinoma: Malatya Experience and Proposals for Expanded Criteria
| Autor: | Mustafa Dikilitas, Fatih Ozdemir, Serdar Karakas, Brian I. Carr, Ilknur Varol, Sezai Yilmaz, Murat Aladağ, Cemalettin Aydin, Bora Barut, Sukru Emre, Abuzer Dirican, Tolga Sahin, Cuneyt Kayaalp, Emrah Otan, Sami Akbulut, Sertac Usta, Dinçer Özgör, Cengiz Ara, Emine Samdanci, Veysel Ersan, Cemalettin Koc, Ramazan Kutlu, Murat Sait Dogan, Volkan Ince, Adil Baskiran, Murat Harputluoglu, Baris Sarici, Burak Isik, Fatih Gonultas, Koray Kutluturk, Harika Gozukara Bag |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular Multivariate analysis medicine.medical_treatment Milan criteria Liver transplantation Malignancy Gastroenterology 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Living Donors Humans Medicine Prospective Studies Survival analysis Retrospective Studies business.industry Liver Neoplasms Middle Aged Prognosis medicine.disease Liver Transplantation Survival Rate Radiation therapy Oncology 030220 oncology & carcinogenesis Hepatocellular carcinoma Cohort Female 030211 gastroenterology & hepatology alpha-Fetoproteins Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Journal of Gastrointestinal Cancer. 51:998-1005 |
| ISSN: | 1941-6636 1941-6628 |
| Popis: | Survival was examined from a Turkish liver transplant center of patients with HCC, to identify prognostic factors. Data from 215 patients who underwent predominantly live donor liver transplant for HCC at our institute over 12 years were included in the study and prospectively recorded. They were 152 patients within and 63 patients beyond Milan criteria. Patients beyond Milan criteria were divided into two groups according to presence or absence of tumor recurrence. Recurrence-associated factors were analyzed. These factors were then applied to the total cohort for survival analysis. We identified four factors, using multivariate analysis, that were significantly associated with tumor recurrence. These were maximum tumor diameter, degree of tumor differentiation, and serum AFP and GGT levels. A model that included all four of these factors was constructed, the 'Malatya criteria.' Using these Malatya criteria, we estimated DFS and cumulative survival, for patients within and beyond these criteria, and found statistically significant differences with improved survival in patients within Malatya criteria of 1, 5, and 10-year overall survival rates of 90.1%, 79.7%, and 72.8% respectively, which compared favorably with other extra-Milan extended criteria. Survival of our patients within the newly defined Malatya criteria compared favorably with other extra-Milan extended criteria and highlight the usefulness of serum AFP and GGT levels in decision-making. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink