Living donor liver transplantation for Patients with beyond Milan hepatocellular carcinoma
Korean Journal of Hepato-Biliary-Pancreatic Surgery
; : 162-167, 2008.
Article
Dans Ko
| WPRIM
| ID: wpr-219557
Responsable en Bibliothèque :
WPRO
ABSTRACT
BACKGROUND:
To find the patients who have a significant chance of cure with living donor liver transplantation (LDLT) among the patients suffering with beyond-Milan hepatocellular carcinoma (HCC), we retrospectively analyzed the tumor factors that could affect a good prognosis after LDLT for patients who suffer with beyond Milan HCC.METHODS:
Between March 2005 and May 2007, 18 cases of LDLT for beyond Milan HCC were performed. None of the patients had preoperative radiological evidence of vascular invasion. Excluding the 3 cases of in-hospital mortality, we analyzed the survival, the disease-free survival and the prognostic factors for recurrence in 15 beyond Milan HCC patients. The mean follow-up period was 18.8degrees +/- 8.8 months (range 4-34 months).RESULTS:
The two-year survival and disease-free survival rates after LDLT were 61.7% and 31.1%, respectively, in 15 beyond-Milan patients. Among them, 9 patients had recurrence of HCC during follow-up. The one-year survival rate after tumor recurrence was 55.5%. An alphafetoprotein (AFP) level < 400 ng/mL, Edmonson-Steiner histology grade I and II and the presence of graft rejection were analyzed as the good prognostic factors of disease-free survival after LDLT for beyond-Milan HCC (p < .05). The patients with negative preoperative positron emission tomography (PET) findings (n = 5) showed a better prognosis than the PET-positive patients (n = 10) with statistical significance (p = .05).CONCLUSION:
Allowing that HCC patients exceed the Milan criteria, we can find the potentially curable candidates for LDLT with using tumor biologic markers such as a serum AFP level < 400 ng/mL, negative PET uptake or low grade histology, as assessed by preoperative needle biopsy. Further investigation is needed to evaluate the relation between graft rejection and tumor recurrence after liver transplantation.
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Pronostic
/
Récidive
/
Stress psychologique
/
Ponction-biopsie à l'aiguille
/
Marqueurs biologiques
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Taux de survie
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Études rétrospectives
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Études de suivi
/
Transplantation hépatique
/
Mortalité hospitalière
Type d'étude:
Observational_studies
/
Prognostic_studies
Limites du sujet:
Humans
langue:
Ko
Texte intégral:
Korean Journal of Hepato-Biliary-Pancreatic Surgery
Année:
2008
Type:
Article