Iacob R, Iacob S, Gheorghe L, Gheorghe C, Hrehoreţ D, Brașoveanu V, Croitoru A, Herlea V, Popescu I
Fundeni Clinical Institute, Bucharest, Romania.
Chirurgia (Bucur). 2013 Jul-Aug;108(4):446-50.
BACKGROUND & AIMS: Liver transplantation (LT) is a promising treatment for patients with liver cirrhosis associated with hepatocellular carcinoma (HCC). The aim of our study was to evaluate our experience regarding the clinical and pathological staging of HCC in patients who underwent LT, as well as recurrence free and overall survival.
From January 2006 to December 2011, 38 patients with diagnosis of HCC, underwent LT in our Center. Demographic, clinical, imaging and pathologic information were recorded. A Cox proportional hazards survival analysis was performed in order to identify significant predictors of tumor recurrence and patient's death after LT.
Eighteen patients (47.4%) in our study group were within Milan criteria. The mean follow-up was 22 months and the recurrence rate of HCC after LT was 13.2%. The 1, 3- year recurrence free survival rates were 85%, 74.3% respectively. The 1 and 3-year overall survival rates were 83.5% and 63.6% respectively. No significant predictor for HCC recurrence was identified in our study group by survival analysis, taking into account 13 different variables. As independent predictors of patient'ss death after LT for HCC however, the presence of diabetes mellitus (p=0.001), presence of more than 3 HCC nodules (p=0.03) and tumor recurrence after LT (p=0.03) were identified by multivariate Cox proportional hazards survival analysis.
In our cohort HCC recurrence rate after LT was 13.2%. Diabetes mellitus, presence of more than 3 HCC nodules and HCC recurrence were significant predictors of poor overall survival after LT.
肝移植(LT)是治疗与肝细胞癌(HCC)相关的肝硬化患者的一种有前景的治疗方法。我们研究的目的是评估我们在接受肝移植的HCC患者的临床和病理分期、无复发生存率和总生存率方面的经验。
2006年1月至2011年12月,38例诊断为HCC的患者在我们中心接受了肝移植。记录了人口统计学、临床、影像学和病理信息。进行了Cox比例风险生存分析,以确定肝移植后肿瘤复发和患者死亡的显著预测因素。
我们研究组中的18例患者(47.4%)符合米兰标准。平均随访时间为22个月,肝移植后HCC的复发率为13.2%。1年、3年无复发生存率分别为85%、74.3%。1年和3年总生存率分别为83.5%和63.6%。在我们的研究组中,通过生存分析,考虑13个不同变量,未发现HCC复发的显著预测因素。然而,通过多变量Cox比例风险生存分析,确定糖尿病的存在(p=0.001)、超过3个HCC结节的存在(p=0.03)和肝移植后肿瘤复发(p=0.03)是HCC肝移植后患者死亡的独立预测因素。
在我们的队列中,肝移植后HCC复发率为13.2%。糖尿病、超过3个HCC结节的存在和HCC复发是肝移植后总体生存不良的显著预测因素。