Role of immunosuppression and tumor differentiation in predicting recurrence after liver transplantation for hepatocellular carcinoma: a multicenter study of 412 patients
| العنوان: | Role of immunosuppression and tumor differentiation in predicting recurrence after liver transplantation for hepatocellular carcinoma: a multicenter study of 412 patients |
|---|---|
| المؤلفون: | Thomas Decaens, Françoise Roudot-Thoraval, Olivier Boillot, François Durand, Solange Bresson-Hadni, Yvon Calmus, Christian Ducerf, Daniel Cherqui, Christophe Duvoux, Pierre-Henri Bernard, Georges Philippe Pageaux, Philippe Compagnon, Sébastien Dharancy, Olivier Chazouillères, Carole Meyer, Jean Hardwigsen, Jean Gugenheim |
| المساهمون: | Service de santé publique [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Service de Chirurgie Digestive / Centre de Transplantation Hépatique [CHU Nice], Centre Hospitalier Universitaire de Nice (CHU Nice), Laboratoire Adaptation et pathogénie des micro-organismes [Grenoble] (LAPM), Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Service de Chirurgie Digestive, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Université de Lille, Droit et Santé, Hôpital Duriez, Service des Maladies de l'Appareil digestif et de la Nutrition, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Chirurgie Digestive et Transplantation Hépatique, Hôpital Archet II, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire Adaptation et pathogénie des micro-organismes [Grenoble] ( LAPM ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Centre National de la Recherche Scientifique ( CNRS ), CHU Cochin [AP-HP], Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Grenouillet, Frédéric |
| المصدر: | World Journal of Gastroenterology World Journal of Gastroenterology, Baishideng Publishing Group Co. Limited, 2006, 12 (45), pp.7319-25 Scopus-Elsevier |
| بيانات النشر: | HAL CCSD, 2006. |
| سنة النشر: | 2006 |
| مصطلحات موضوعية: | Oncology, Pathology, MESH : Liver Neoplasms, medicine.medical_treatment, MESH : Analysis of Variance, Liver transplantation, MESH: Proportional Hazards Models, MESH: Cause of Death, 0302 clinical medicine, MESH: Liver Neoplasms, Cause of Death, MESH: Carcinoma, Hepatocellular, [ SDV.MP.MYC ] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Cause of death, MESH : Neoplasm Recurrence, Local, Liver Neoplasms, Gastroenterology, MESH: Immunosuppression, Immunosuppression, General Medicine, MESH: Predictive Value of Tests, 3. Good health, surgical procedures, operative, 030220 oncology & carcinogenesis, Predictive value of tests, Hepatocellular carcinoma, MESH: Survival Analysis, MESH : Disease-Free Survival, 030211 gastroenterology & hepatology, MESH: Neoplasm Recurrence, Local, Rapid Communication, MESH : Carcinoma, Hepatocellular, medicine.medical_specialty, MESH: Liver Transplantation, Carcinoma, Hepatocellular, Disease-Free Survival, MESH: Multivariate Analysis, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, MESH: Analysis of Variance, medicine, Carcinoma, Humans, MESH : Predictive Value of Tests, Survival analysis, Proportional Hazards Models, MESH : Cause of Death, Immunosuppression Therapy, Analysis of Variance, MESH: Humans, business.industry, Proportional hazards model, MESH : Humans, MESH : Multivariate Analysis, medicine.disease, MESH : Proportional Hazards Models, Survival Analysis, [SDV.MP.MYC] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, digestive system diseases, Liver Transplantation, Multivariate Analysis, MESH : Immunosuppression, MESH: Disease-Free Survival, Neoplasm Recurrence, Local, MESH : Survival Analysis, MESH : Liver Transplantation, business |
| الوصف: | International audience; AIM: To assess pre-orthotopic liver transplantation (OLT) factors that could be evaluated pre-operatively or controlled post-operatively associated with hepatocellular carcinoma (HCC) recurrence and disease-free survival after liver transplantation (LT). METHODS: Four hundred and twelve patients transplanted for HCC between 1988 and 1998 in 14 French centers, who survived the postoperative period were studied. Kaplan Meier estimates were calculated for 24 variables potentially associated with recurrence of HCC. Uni- and multivariate analyses were conducted to identify independent predictors of recurrence. RESULTS: Overall 5-year disease-free survival was 57.1%. By univariate analysis, variables associated with disease-free survival were: presence of cirrhosis (P = 0.001), etiology of liver disease (P = 0.03), alpha fetoprotein level (< 200, 200 to 2000, or > 2000; P < 0.0001), gamma-GT activity (N, N to 2N or > 2N; P = 0.02), the number of nodules (1, 2-3 or > or = 4; P = 0.02), maximal diameter of the largest nodule (< 3 cm, 3 to 5 cm or > 5 cm; P < 0.0001), the sum of the diameter of the nodules (< 3 cm, 3 to 5 cm, 5 to 10 cm or > 10 cm; P < 0.0001), bi-lobar location (P = 0.01), preoperative portal thrombosis (P < 0.0001), peri-operative treatment of the tumor (P = 0.002) and chemoembolization (P = 0.03), tumor differentiation (P = 0.01), initial type of calcineurin inhibitor (P = 0.003), the use of antilymphocyte antibodies (P = 0.02), rejection episodes (P = 0.003) and period of LT (P < 0.0001). By multivariate analysis, 6 variables were independently associated with HCC recurrence: maximal diameter of the largest nodule (P < 0.0001), time of LT (P < 0.0001), tumor differentiation (P < 0.0001), use of anti-lymphocyte antibody (ATG) or anti-CD3 antibody (OKT3) (P = 0.005), preoperative portal thrombosis (P = 0.06) and the number of nodules (P = 0.06). CONCLUSION: This study identifies immunosuppression, through the use of ATG or OKT3, as a predictive factor of tumor recurrence, and confirms the prognostic value of tumor differentiation. |
| اللغة: | English |
| تدمد: | 1007-9327 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6adfb0507b37c8d3dc5a4bb6efd8d2e7Test https://hal.archives-ouvertes.fr/hal-00483832Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....6adfb0507b37c8d3dc5a4bb6efd8d2e7 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10079327 |
|---|