Predictive Factors of Outcome After Liver Transplantation in Patients With Cirrhosis and Hepatocellular Carcinoma
| Autor: | S. Ginanni Corradini, Manuela Merli, Massimo Iappelli, Gilnardo Novelli, Gianluca Mennini, Oliviero Riggio, Francesco Nudo, A. Onetti Muda, G. Nicolini, F. Gentili, P.B. Berloco, G. Casciaro, Irene Pecorella, U. Di Tondo, Massimo Rossi, Adolfo Francesco Attili, A. Marasco |
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| Rok vydání: | 2005 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Carcinoma Hepatocellular Multivariate analysis Cirrhosis medicine.medical_treatment Liver transplantation Milan criteria Single Center Gastroenterology Predictive Value of Tests Internal medicine medicine Humans Retrospective Studies Transplantation business.industry Liver Neoplasms Middle Aged Prognosis medicine.disease Survival Analysis Liver Transplantation Treatment Outcome Lymphatic Metastasis Hepatocellular carcinoma Cohort Female Surgery business |
| Zdroj: | Transplantation Proceedings. 37:2535-2540 |
| ISSN: | 0041-1345 |
| Popis: | Studies to define the optimal upper limits of tumor size and number as predictors of outcome after orthotopic liver transplantation (OLT) have yielded conflicting results. We analyzed 72 patients with cirrhosis and hepatocellular carcinoma (HCC) who underwent OLT over a 12-year period in a single center. Predictive factors for survival and tumor recurrence, according to the Milan criteria, were also examined. Our cohort included 60 men and 12 women of mean age 54 +/- 8 years and mean follow-up of 40 +/- 39 months. Origin of cirrhosis was postviral in 70% and Child class B or C in two thirds of patients. HCC was multifocal in 61%; about one fifth of patients had micro- or macrovascular involvement or positive nodes upon histologic examination. The cumulative size of the lesions was3 cm in 17 patients;3 toor =5 cm in 28 patients;5 toor =8 cm in 14 patients; and8 cm in 13 patients. According to the number and size of tumor nodules, 49 patients met the Milan criteria. During follow-up 25 patients died, 13 due to tumor recurrence. The 1- and 2-year survivals were 90% and 85% for patients who met the Milan criteria versus 57% and 51% for patients exceeding those limits (P = .006). A cumulative tumor size8 cm was predictive of survival and tumor recurrence upon multivariate analysis. The adoption of Milan criteria for selection of cirrhotic patients has improved survival and reduced the rate of tumor recurrence. The evaluation of cumulative tumor size might further improve patient selection. |
| Databáze: | OpenAIRE |
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