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Factors affecting survival and tumor recurrence in patients transplanted for hepatocellular carcinoma and coexistent hepatitis C virus.

Abstract：

:A better understanding of tumor factors influencing patient and graft survival and recurrence of hepatocellular carcinoma (HCC) associated with hepatitis C virus (HCV) cirrhosis may be useful to maximize the benefits of liver transplantation (OLT). Sixty-three adults underwent OLT for end-stage liver disease secondary to HCV with concomitant HCC. The outcome measures were patient and graft survival, as well as recurrence-free survival, computed using a stepwise Cox proportional hazards regression analysis. Kaplan-Meier 1-, 3-, and 5-year patient survival rates were 82%, 80%, and 69%, respectively, they were better for incidentally discovered HCC compared with preoperatively diagnosed HCC (P = .04). The overall recurrence-free survival rates were 81%, 76%, and 61% at 1, 3, and 5 years, respectively. Univariate analysis showed that nonincidental HCC (P = .04), pTNM stage (P = .012) and vascular invasion (P = .003) correlated with recipient mortality. Vascular invasion (odds ratio [OR] = 2.12; P = .001) and pTNM (OR = 1.50; P = .008) were independent predictors of overall survival. A combination of tumor vascular invasion with advanced pTNM was associated with a dismal prognosis (log-rank = 21.89; P = .0001). Tumor grading (OR = 1.2; P = .04), pTNM (OR = 3.7; P = .001) and vascular invasion (OR = 1.6; P = .002) were independent predictors of recurrence. In conclusion, advanced pTNM and the presence of vascular invasion are strong predictors of poor survival and tumor recurrence.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Briceño J,Ruiz J,Ciria R,Naranjo A,Sánchez-Hidalgo J,Luque A,Rufián S,de la Mata M,López-Cillero P

doi

10.1016/j.transproceed.2008.09.022

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

2990-3

issue

9

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(08)01281-5

journal_volume

40

pub_type

杂志文章

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