Single-Center Experience of Recurrence Patterns and Survival Analyses of Patients With Hepatocellular Carcinoma and Liver Transplant
| العنوان: | Single-Center Experience of Recurrence Patterns and Survival Analyses of Patients With Hepatocellular Carcinoma and Liver Transplant |
|---|---|
| المؤلفون: | Gokhano Moray, Mehmet Haberal, Ozden Altundag, Ebru H. Ayvazoglu Soy, Samed Rahatli, Arzu Oguz |
| المصدر: | Experimental and Clinical Transplantation. 18:201-205 |
| بيانات النشر: | Baskent University, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Time Factors, Turkey, Milan criteria, Single Center, Risk Assessment, Gastroenterology, Risk Factors, Internal medicine, Humans, Medicine, In patient, Aged, Retrospective Studies, Transplantation, medicine.diagnostic_test, business.industry, Liver Neoplasms, Cancer, Interventional radiology, Middle Aged, medicine.disease, Progression-Free Survival, Liver Transplantation, Time to recurrence, Hepatocellular carcinoma, Disease Progression, Female, Neoplasm Recurrence, Local, business, Median survival |
| الوصف: | OBJECTIVES Hepatocellular carcinoma remains a major health problem with increased rates of mortality. The curative treatment options are resection or liver transplant. Because the Milan criteria are restrictive for candidates, they have been expanded into alternative sets of criteria. We aimed to evaluate our indications for liver transplant and their results for hepatocellular carcinoma. MATERIALS AND METHODS Between December 1988 and January 2020, we performed 652 liver transplant procedures (443 living donors, 209 deceased donors) at Baskent University (Ankara, Turkey). At Baskent University, we developed liver transplant criteria for patients with hepatocellular carcinoma. For our criteria, liver transplant for hepatocellular carcinoma was performed in patients without major vascular invasion and distant metastasis. Clinical data on cancer demographics, recurrence patterns, and survival outcomes were evaluated retrospectively. RESULTS Of 652 total patients, 49 adult patients (8%) with diagnosis of hepatocellular carcinoma were included in this study. Median age was 55 years. Hepatocellular carcinoma recurrence after liver transplant was detected in 13 patients. Median overall survival was 64.3 months for all study patients; however, median survival was significantly lower in patients who had recurrence (126.3 vs 43.4 mo for nonrecurrent vs recurrent groups; P = .024). In the expanded criteria group (n = 25), 7 patients (28%) had hepatocellular carcinoma recurrence during follow-up, whereas this ratio was 25% (6/24 patients) in the Milan criteria group, with median time to recurrence of 12.6 versus 11.7 months, respectively (not significantly different). CONCLUSIONS Multidisciplinary treatment modalities, including surgery, interventional radiology techniques, and medical treatments, will probably lead to prolonged survival in patients with hepatocellular carcinoma. According to our center's expanded criteria, recurrence rates and time to recurrence were similar to those shown with the Milan group. We showed that Milan criteria can be safely expanded with promising results even in patients beyond Milan criteria. |
| تدمد: | 2146-8427 1304-0855 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9c51020b4010126aacb2a41543a1977aTest https://doi.org/10.6002/ect.2020.0046Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9c51020b4010126aacb2a41543a1977a |
| قاعدة البيانات: | OpenAIRE |
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The curative treatment options are resection or liver transplant. Because the Milan criteria are restrictive for candidates, they have been expanded into alternative sets of criteria. We aimed to evaluate our indications for liver transplant and their results for hepatocellular carcinoma. MATERIALS AND METHODS Between December 1988 and January 2020, we performed 652 liver transplant procedures (443 living donors, 209 deceased donors) at Baskent University (Ankara, Turkey). At Baskent University, we developed liver transplant criteria for patients with hepatocellular carcinoma. For our criteria, liver transplant for hepatocellular carcinoma was performed in patients without major vascular invasion and distant metastasis. Clinical data on cancer demographics, recurrence patterns, and survival outcomes were evaluated retrospectively. RESULTS Of 652 total patients, 49 adult patients (8%) with diagnosis of hepatocellular carcinoma were included in this study. Median age was 55 years. Hepatocellular carcinoma recurrence after liver transplant was detected in 13 patients. Median overall survival was 64.3 months for all study patients; however, median survival was significantly lower in patients who had recurrence (126.3 vs 43.4 mo for nonrecurrent vs recurrent groups; P = .024). In the expanded criteria group (n = 25), 7 patients (28%) had hepatocellular carcinoma recurrence during follow-up, whereas this ratio was 25% (6/24 patients) in the Milan criteria group, with median time to recurrence of 12.6 versus 11.7 months, respectively (not significantly different). CONCLUSIONS Multidisciplinary treatment modalities, including surgery, interventional radiology techniques, and medical treatments, will probably lead to prolonged survival in patients with hepatocellular carcinoma. According to our center's expanded criteria, recurrence rates and time to recurrence were similar to those shown with the Milan group. 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