Organ Transplantation Center, Changzheng Hospital, Second Military Medical University, Shanghai, China University of Arkansas for Medical Sciences, Shanghai, China.
Clin Transplant. 2010 Nov-Dec;24(6):752-7. doi: 10.1111/j.1399-0012.2009.01172.x.
Liver transplantation (LT) was advocated as a salvage treatment of choice for patients with unresectable hepatocellular carcinoma (HCC). This study was designed to assess the eligibility of LT criteria for patients with HCC and to analyze the factors influencing the recurrence of HCC following LT, aiming to further improve the efficacy of LT for patients with HCC.
Clinical data of 255 patients with HCC who underwent LT between December 2001 and December 2007 at Shanghai Changzheng Hospital, China were retrospectively analyzed.
Among these cases, 75 patients were within the Milan criteria and 180 were beyond it; 110 patients were within the University of California, San Francisco (UCSF) criteria, while 145 were beyond it. The difference in overall survival rates was not only significant between the patients within and beyond the Milan criteria but also between patients within and beyond the UCSF criteria. Tumor-node-metastasis (TNM) staging, portal vein tumor thrombus (PVTT), and the pre-operative alpha-fetoprotein (AFP) level were independent risk factors affecting the overall survival and post-operative recurrence-free survival rates of patients with HCC. Pathological staging and pre-operative local treatment of HCC had no obvious correlation with the post-operative recurrence-free survival rate.
LT is an effective treatment modality for HCC. The UCSF criteria did not show better effectiveness than the Milan criteria. TNM staging, PVTT, and the pre-operative AFP level are closely related to the recurrence of HCC following LT.
肝移植（LT）被认为是不可切除肝细胞癌（HCC）患者的首选挽救治疗方法。本研究旨在评估 LT 标准对 HCC 患者的适用性，并分析影响 LT 后 HCC 复发的因素，旨在进一步提高 LT 治疗 HCC 患者的疗效。
回顾性分析 2001 年 12 月至 2007 年 12 月在中国上海长征医院接受 LT 的 255 例 HCC 患者的临床资料。
在这些病例中，75 例符合米兰标准，180 例超出米兰标准；110 例符合加利福尼亚大学旧金山分校（UCSF）标准，145 例超出 UCSF 标准。在米兰标准内和超出米兰标准的患者以及在 UCSF 标准内和超出 UCSF 标准的患者之间，总生存率的差异不仅显著，而且无复发生存率的差异也显著。肿瘤-淋巴结-转移（TNM）分期、门静脉癌栓（PVTT）和术前甲胎蛋白（AFP）水平是影响 HCC 患者总生存率和术后无复发生存率的独立危险因素。病理分期和 HCC 的术前局部治疗与术后无复发生存率无明显相关性。
LT 是 HCC 的有效治疗方法。UCSF 标准并不比米兰标准更有效。TNM 分期、PVTT 和术前 AFP 水平与 LT 后 HCC 的复发密切相关。
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