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肝移植后肝细胞癌患者的预后

Outcomes of Patients With Hepatocellular Carcinoma After Liver Transplant.

作者信息

Moray Gokhan, Kirnap Mahir, Akdur Aydincan, Soy Ebru, Tezcaner Tugan, Boyvat Fatih, Ozdemir Handan, Haberal Mehmet

机构信息

From the Department of General Surgery and Transplantation, Baskent University School of Medicine, Ankara, Turkey.

出版信息

Exp Clin Transplant. 2015 Nov;13 Suppl 3:30-2. doi: 10.6002/ect.tdtd2015.O22.

Abstract

OBJECTIVES

Liver transplant is one of the few effective treatments for hepatocellular carcinoma. Our aim in this study was to evaluate the risk factors for hepatocellular carcinoma recurrence after liver transplant.

MATERIALS AND METHODS

In this retrospective study, conducted between October 1988 and March 2015, four hundred seventy-three liver transplants were performed at our institution. Of these, 231 were pediatric and 242 were adult. Among these patients, liver transplant was performed in 58 patients (12.3%) for treatment of hepatocellular carcinoma.

RESULTS

Hepatocellular carcinoma recurrence was detected in 14 patients (24.1%). Overall 5-year and 10-year survival rates of patients underwent liver transplant beyond the Milan criteria for hepatocellular carcinoma were 50.3% and 43.1%. Overall, 5- and 10-year survival rates of patients underwent liver transplant within the Milan criteria for hepatocellular carcinoma were 78.4% and 72.6%. The main predictive variable was whether the tumor had expensed beyond the Milan criteria.

CONCLUSIONS

As expected, outcomes were significantly better in the Milan criteria group. Although the overall- and disease-free survival rates were promising in such a group of patients who had no better chance, it could be asserted that liver transplant is a safe and effective treatment option with promising results, even if the tumor expanse is beyond the Milan criteria.

摘要

目的

肝移植是肝细胞癌为数不多的有效治疗方法之一。本研究的目的是评估肝移植后肝细胞癌复发的危险因素。

材料与方法

在这项回顾性研究中,于1988年10月至2015年3月期间在我们机构进行了473例肝移植手术。其中,231例为儿童患者,242例为成人患者。在这些患者中,58例(12.3%)因肝细胞癌接受了肝移植治疗。

结果

14例患者(24.1%)检测到肝细胞癌复发。肝细胞癌超出米兰标准接受肝移植患者的总体5年和10年生存率分别为50.3%和43.1%。总体而言,肝细胞癌在米兰标准内接受肝移植患者的5年和10年生存率分别为78.4%和72.6%。主要预测变量是肿瘤是否超出米兰标准。

结论

正如预期的那样,米兰标准组的结果明显更好。尽管在这类没有更好机会的患者中总体生存率和无病生存率很可观,但可以断言,即使肿瘤范围超出米兰标准,肝移植仍是一种安全有效的治疗选择,结果令人满意。

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