Vennarecci G, Ettorre G M, Antonini M, Santoro R, Maritti M, Tacconi G, Spoletini D, Tessitore L, Perracchio L, Visco G, Puoti C, Santoro E
Division of Surgical Oncology and Liver Transplantation, Regina Elena Cancer Institute, Rome, Italy.
Transplant Proc. 2007 Jul-Aug;39(6):1857-60. doi: 10.1016/j.transproceed.2007.05.073.
The present study focused on nine patients with hepatocellular carcinoma (HCC) associated with Child A liver cirrhosis undergoing first-line liver resection and salvage liver transplantation (SLT) for liver tumor recurrence.
Forty-six patients with HCC underwent liver transplantation (OLT); 37 (80.5%) were primary liver transplantations (PLTs) and 9 (19.5%) were SLTs. All patients who underwent SLT received minor transabdominal liver resections.
The posttransplant 1-, 3-, and 5-year overall survival rates for SLT (88.9%, 88.9%, and 88.9%) were similar to those for PLT (78%, 62.7%, and 62.7%). Four (10.8%) patients in the PLT group had HCC recurrence, while there was zero recurrence in the SLT group. The 1-, 3-, 5-year disease-free survival rates for PLT (89%, 74%, and 74%) were similar to those for SLT (100%, 100%, and 100%). The 1-, 3-, 5-year disease-free survival rates after PLT were 89%, 74%, and 74%, and after SLT were 100%, 100%, and 100%, respectively. The operative mortality, intraperioperative bleeding, operative time, intensive care unit stay, in-hospital stay, and overall incidence of postoperative complications were similar in the two groups.
In our experience, SLT for HCC is a feasible procedure with similar results in terms of overall survival, disease-free survival, and postoperative complications to those reported for patients who underwent PLT at our institute. An important role exists for SLT as shown by the fact that such a strategy has been used in the 20% of the patients undergoing OLT for HCC.
本研究聚焦于9例患有肝细胞癌（HCC）且伴有Child A级肝硬化的患者，他们接受了一线肝切除及针对肝肿瘤复发的挽救性肝移植（SLT）。
46例HCC患者接受了肝移植（OLT）；37例（80.5%）为初次肝移植（PLT），9例（19.5%）为SLT。所有接受SLT的患者均接受了经腹小肝切除术。
SLT术后1年、3年和5年的总生存率（分别为88.9%、88.9%和88.9%）与PLT术后的总生存率（分别为78%、62.7%和62.7%）相似。PLT组有4例（10.8%）患者出现HCC复发，而SLT组复发率为零。PLT术后1年、3年、5年的无病生存率（分别为89%、74%和74%）与SLT术后的无病生存率（分别为100%、100%和100%）相似。PLT术后1年、3年、5年的无病生存率分别为89%、74%和74%，SLT术后分别为100%、100%和100%。两组的手术死亡率、围手术期出血、手术时间、重症监护病房停留时间、住院时间以及术后并发症的总发生率相似。
根据我们的经验，HCC的SLT是一种可行的手术，在总生存率、无病生存率以及术后并发症方面，其结果与我院接受PLT的患者所报告的结果相似。SLT发挥着重要作用，这一策略已应用于20%接受OLT治疗HCC的患者中，事实即证明了这一点。
