Living donor liver transplantation for Patients with beyond Milan hepatocellular carcinoma
Korean Journal of Hepato-Biliary-Pancreatic Surgery
; : 162-167, 2008.
Article
em Ko
| WPRIM
| ID: wpr-219557
Biblioteca responsável:
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.Palavras-chave
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Índice:
WPRIM
Assunto principal:
Prognóstico
/
Recidiva
/
Estresse Psicológico
/
Biópsia por Agulha
/
Biomarcadores
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Taxa de Sobrevida
/
Estudos Retrospectivos
/
Seguimentos
/
Transplante de Fígado
/
Mortalidade Hospitalar
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
Ko
Revista:
Korean Journal of Hepato-Biliary-Pancreatic Surgery
Ano de publicação:
2008
Tipo de documento:
Article