Dr. Rela Institute and Medical Centre, 7, CLC Works Road, Chromepet, Chennai, 600 044, India.
Bharat Institute of Higher Education and Research, 7, CLC Works Road, Chrompet, Chennai, 600 044, India.
Indian J Gastroenterol. 2021 Feb;40(1):30-34. doi: 10.1007/s12664-020-01127-7. Epub 2021 Feb 6.
The impact of incidentally detected hepatocellular carcinoma (iHCC) in explanted liver on the prognosis of the patients undergoing orthotopic liver transplantation remains controversial with several studies reporting survival worse than true non-hepatocellular carcinoma (non-HCC) recipients. Patients undergoing living donor liver transplantation (LDLT) have the benefit of a shorter waiting time to transplant which in principle should reduce the frequency of new tumors developing while waiting for transplant. We aimed to evaluate the incidence, histopathological features, and impact of iHCC on short- and long-term outcomes in adult LDLT recipients.
The present study retrospectively analyzed the patients' demographics, tumor characteristics, and outcomes of iHCC in adult patients undergoing LDLT for non-HCC indications at our center between August 2009 and March 2018.
Five hundred and forty-five adults underwent LDLT in our center during the study period. iHCC was detected in the explanted livers in 28 patients (5.1%) out of 545 LDLTs. Only one patient had iHCC beyond Milan criteria. No tumor recurrence was observed in the iHCC cohort after a median follow-up of 28 months. Five-year overall and recurrence-free survival was 96.4%.
Incidence of iHCC in explanted livers after LDLT is low and most patients have very early-stage tumors with excellent recurrence-free survival. Hence, no specific post-transplant surveillance or treatment is necessary.
偶然发现的肝细胞癌（iHCC）对接受原位肝移植患者的预后的影响仍存在争议，一些研究报告称其生存率低于真正的非肝细胞癌（non-HCC）受者。接受活体供肝移植（LDLT）的患者有接受移植前等待时间更短的优势，这在原则上应该减少在等待移植期间新肿瘤发展的频率。我们旨在评估 iHCC 在本中心接受非 HCC 指征 LDLT 的成年患者中的发生率、组织病理学特征以及对短期和长期结局的影响。
本研究回顾性分析了 2009 年 8 月至 2018 年 3 月期间本中心接受 LDLT 的非 HCC 指征的成年患者的人口统计学、肿瘤特征和 iHCC 结局。
在研究期间，545 名成年人在本中心接受 LDLT。在 545 例 LDLT 中，28 例（5.1%）患者的供肝中发现了 iHCC。仅有 1 例患者的 iHCC 超出米兰标准。在中位随访 28 个月后，iHCC 组未观察到肿瘤复发。5 年总生存率和无复发生存率分别为 96.4%。
LDLT 后供肝中 iHCC 的发生率较低，大多数患者的肿瘤处于非常早期阶段，无复发生存率极好。因此，不需要进行特定的移植后监测或治疗。
