Changing Paradigm in the Surgical Management of Hepatocellular Carcinoma With Salvage Transplantation.
Transplant Proc
; 50(4): 1087-1093, 2018 May.
Article
em En
| MEDLINE
| ID: mdl-29731072
ABSTRACT
OBJECTIVE:
The objective of this study was to compare the long-term outcomes of primary and salvage liver transplantation for patients with hepatocellular carcinoma (HCC).METHOD:
This was a 10-year retrospective analysis in a tertiary referral center.RESULTS:
There were 184 patients recruited (primary liver transplantation [pLT]salvage liver transplantation [sLT], 14341). The median follow-up time was 79 months. Operation time was shorter in the pLT group than the sLT group (661 ± 164 minutes vs 754 ± 206 minutes; P = .01) and the blood loss was 3749 mL and 3545 mL for pLT and sLT, respectively (P = .735). The reoperation rate was 5.6% and 4.9%, respectively (P = 1.0). The 5-year overall and disease-free survival rates from the time of transplantation for pLT and sLT were 84.1% versus 70.2% (P = .01) and 82.2% versus 65.8% (P = .01), respectively. The 5-year overall survival rate from the time of primary treatment for sLT was 80.3% (P = .1). Subgroup analysis of sLT showed that young age (50 vs 56 year old; P = .004) was the only factor associated with poor overall survival. Young age (P = .004) and microvascular permeation (P = .008) in the recurrent tumor were associated with HCC recurrence. Young age stands out to be the only independent factor associated with HCC recurrence.CONCLUSION:
sLT is the treatment of choice for patients with recurrent HCC in regions of graft shortage.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transplante de Fígado
/
Terapia de Salvação
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Carcinoma Hepatocelular
/
Neoplasias Hepáticas
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article