Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, 610041, China.
J Gastrointest Surg. 2013 Jun;17(6):1116-22. doi: 10.1007/s11605-013-2140-6. Epub 2013 Jan 17.
In Mainland China, many selection criteria for hepatocellular carcinoma (HCC) liver transplantation, such as the Hangzhou, the Chengdu, and the Fudan criteria, have been established. No comparisons have been made among the outcomes using the Hangzhou, Chengdu, and University of California, San Francisco (UCSF) criteria in patients who underwent successful downstaging therapies.
After successful downstaging therapies, 72 patients met the UCSF criteria, 86 met the Chengdu criteria, and 102 met the Hangzhou criteria. The data on these HCC patients were retrospectively analyzed, and various outcomes, such as survival and the tumor-free survival rate, were compared among the three groups.
No significant differences were observed among the three groups with regard to the downstaging protocols, baseline characteristics, or liver function. However, the patients who met the Hangzhou criteria had significantly larger tumor targets than those who met the Chengdu or UCSF criteria (P < 0.05). The three groups showed similar 1-, 3-, and 5-year survival rates (90.9, 80.0, and 78.6 %, respectively, for the UCSF criteria; 91.6, 81.9, and 75.6 %, respectively, for the Hangzhou criteria; and 91.1, 83.3, and 79.4 %, respectively, for the Chengdu criteria); 1-, 3-, and 5-year tumor-free survival rates (83.3, 77.5, and 75 %, respectively, for the UCSF criteria; 86.3, 78.8, and 75.6 %, respectively, for the Hangzhou criteria; and 87.3, 79.2, and 76.4 %, respectively, for the Chengdu criteria); and 1-, 3-, and 5-year tumor recurrence rates (9.2, 17.5, and 21.4 %, respectively, for the UCSF criteria; 8.4, 16.4, and 20 % for the Hangzhou criteria; and 8.9, 14.6, and 17.6 % for the Chengdu criteria).
Because they have contributed to similar outcomes but to larger HCC patient pools, the Hangzhou criteria for HCC transplantation should be comprehensively accepted in China for HCC patients after successful downstaging therapies.
在中国内地，已经建立了许多肝癌（HCC）肝移植的选择标准，如杭州标准、成都标准和加州大学旧金山分校（UCSF）标准。但是，对于接受成功降期治疗的患者，尚未对杭州标准、成都标准和 UCSF 标准的结果进行比较。
在成功降期治疗后，有 72 例患者符合 UCSF 标准，86 例患者符合成都标准，102 例患者符合杭州标准。对这些 HCC 患者的数据进行回顾性分析，并比较三组患者的生存和无肿瘤生存率等各种结果。
三组患者在降期方案、基线特征或肝功能方面无显著差异。但是，符合杭州标准的患者肿瘤靶标明显大于符合成都或 UCSF 标准的患者（P<0.05）。三组患者的 1 年、3 年和 5 年生存率相似（UCSF 标准组分别为 90.9%、80.0%和 78.6%；杭州标准组分别为 91.6%、81.9%和 75.6%；成都标准组分别为 91.1%、83.3%和 79.4%）；1 年、3 年和 5 年无肿瘤生存率相似（UCSF 标准组分别为 83.3%、77.5%和 75%；杭州标准组分别为 86.3%、78.8%和 75.6%；成都标准组分别为 87.3%、79.2%和 76.4%）；1 年、3 年和 5 年肿瘤复发率相似（UCSF 标准组分别为 9.2%、17.5%和 21.4%；杭州标准组分别为 8.4%、16.4%和 20%；成都标准组分别为 8.9%、14.6%和 17.6%）。
由于杭州标准为更大的 HCC 患者群体带来了相似的结果，因此应该在中国全面接受杭州标准作为 HCC 患者接受成功降期治疗后的肝移植选择标准。
