Liver transplantation for hepatocellular carcinoma: prognostic factors associated long-term survival

Transplant International : Official Journal of the European Society for Organ Transplantation
G ColellaD Forti

Abstract

Between December 1985 and February 1995, 260 orthotopic liver transplantations (OLTX) were performed on 238 patients at Niguarda Hospital. Sixty-three patients had hepatocellular carcinoma (HCC); in 13 of the patients HCC was incidental. All patients had negative lymph nodes. According to the Child classification, 13 patients were Child A, 30 Child B, and 18 Child C. According to the TNM classification, 11 patients were stage I, 22 stage II, 15 stage III, and 15 stage IVa. Pre-OLTX chemoembolization was performed on 25 patients. The perioperative mortality rate was 27% (17 patients). Overall survival and disease-free actuarial survival rates at 1, 3, and 5 years were 94%, 76%, 76%, and 83%, 75%, 75%, respectively. Survival curves were compared for 16 different variables. No difference was observed for all parameters analyzed except tumor site, TNM stage, pre-OLTX AFP levels and vascular infiltration. These results seem to demonstrate that the OLTX for unresectable HCC can be considered in specifically selected cases as the treatment of choice. An adequate tumor staging is also necessary for a better patient selection in order to increase survival.

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Citations

Jun 6, 2003·Journal of the American College of Surgeons·Luciano De CarlisDomenico Forti
May 1, 2002·Annals of Surgery·Jeffrey D WayneJean-Nicolas Vauthey
Mar 25, 2010·Cancer Chemotherapy and Pharmacology·G NastiR V Iaffaioli
Mar 13, 2010·Bioinformatics·Kim-Anh Lê CaoGeoffrey J McLachlan

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