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Liver transplantation for hepatocellular carcinoma: our experience from 1986.

Abstract：

UNLABELLED:Currently liver transplantation is the treatment of choice for early hepatocellular carcinoma and end-stage liver disease. We analyzed our experience to identify factors that could be used to select patients who will benefit from liver transplantation. PATIENTS AND METHODS:From April 1986 to December 2001, 71 (8.7%) of 816 LT performed in our institution, were for patients with hepatocellular carcinoma. In 25 patients the tumor was observed incidental by (35.2%). All patients had liver cirrhosis, most due to hepatitis C related (35) or alcoholic (14) diseases. Before liver transplantation, chemoembolization was performed in 18 patients (25.4%). RESULTS:Bilateral involvement was present in seven patients. Eight patients showed macroscopic vascular invasion, and eight others showed satellite nodules. Most patients were stage TNM II (29) and IVa (16). Overall 1-, 3-, and 5-year survival were 79.3%, 61%, and 50.3% with recurrence-free survivals of 74.6%, 57.5%, and 49%, respectively. With a mean follow-up of 42 months, 12 patients (19%) developed recurrence and 29 patients died (only 11 due to recurrence). Stage TNM IVa, macroscopic vascular invasion, and the presence of satellite nodules significantly affected overall survival and recurrence-free survival rates and histologic differentiation and bilateral involvement only recurrence-free survival. Patients with solitary tumors less than 5 cm or no more than three nodules smaller than 3 cm showed better recurrence-free survival and lower recurrence rates. DISCUSSION:In our experience, liver transplantation proffers good recurrence-free survival and low recurrence rates among patients with limited tumor extension. The most important prognostic factor was macroscopic vascular invasion.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Pérez Saborido B,Loinaz Segurola C,Gimeno Calvo A,Meneu Díaz JC,Abradelo de Usera M,Calvo Pulido J,Jiménez Romero C,Gómez Sanz R,García García I,Moreno González E

doi

10.1016/s0041-1345(03)00581-5

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

1825-6

issue

5

eissn

0041-1345

issn

1873-2623

pii

S0041134503005815

journal_volume

35

pub_type

杂志文章

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