Comparative analysis of outcomes after liver resection and liver transplantation for early stages hepatocellular carcinoma in HIV-infected patients. An intention-to-treat analysis
| Autor: | Didier Samuel, Daniel Cherqui, Nicolas Golse, Pablo Duarte, Andrea Fontana, Jean Charles Duclos-Vallée, Denis Castaing, Vincent Karam, Cristiane Bündchen, René Adam, Gabriella Pittau, A. Sa Cunha, Eric Vibert, Marc-Antoine Allard, Oriana Ciacio |
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| Přispěvatelé: | Physiopathologie et traitement des maladies du foie, Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Génétique des tumeurs (U985), Institut Gustave Roussy (IGR)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Écologie et santé des écosystèmes (ESE), AGROCAMPUS OUEST, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CCSD, Accord Elsevier, Hôpital Paul Brousse, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), DHU Hepatinov [Villejuif], Federal University of Health Sciences of Porto Alegre = Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Carcinoma Hepatocellular medicine.medical_treatment [SDV]Life Sciences [q-bio] Population Human immunodeficiency virus (HIV) Liver transplantation medicine.disease_cause Gastroenterology Resection 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Hiv infected patients Hepatectomy Humans education Retrospective Studies education.field_of_study Intention-to-treat analysis Hepatology business.industry Liver Neoplasms medicine.disease 3. Good health Intention to Treat Analysis Liver Transplantation [SDV] Life Sciences [q-bio] 030220 oncology & carcinogenesis Hepatocellular carcinoma Portal hypertension 030211 gastroenterology & hepatology Neoplasm Recurrence Local business |
| Zdroj: | HPB HPB, Wiley, 2020, 22, pp.900-910. ⟨10.1016/j.hpb.2019.10.014⟩ HPB, 2020, 22, pp.900-910. ⟨10.1016/j.hpb.2019.10.014⟩ |
| ISSN: | 1365-182X 1477-2574 |
| DOI: | 10.1016/j.hpb.2019.10.014⟩ |
| Popis: | International audience; Background: To address the results of resection for hepatocellular carcinoma (HCC) in human immunodeficiency virus (HIV)-carriers, and to compare them against survival after liver transplantation (LT).Methods: All patients with HIV and HCC listed for LT (candidates = LTc+) or resection (LR+) between 2000 and 2017 in our centre were analysed and compared for overall survival (OS) and disease-free survival (DFS).Results: The LTc + group (n = 43) presented with higher MELD scores and more advanced portal hypertension and HCC stages than LR + group (n = 15). One-, 3- and 5-year intention-to-treat survival rates were: 81%, 60% and 44%, versus 86%, 58% and 58% in the LTc+ and LR + groups, respectively (p = 0.746). Eleven LTc + patients dropped out. After LT, OS was 81%, 68% and 59% (no difference with LR + group; p = 0.844). There tended to be better DFS after LT, reaching 78%, 68% and 56% versus 53%, 33% and 33% in the LR + group (p = 0.062).Conclusion: This was the largest series of resections for HCC in HIV + patients and the first intention-to-treat analysis. Although LT and resection do not always concern the same population, they enable equivalent survival. At the price of higher recurrence rate, resection could be integrated in the global armoury of liver surgeons. |
| Databáze: | OpenAIRE |
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