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Benefit of downsizing hepatocellular carcinoma in a liver transplant population
| Content Provider | Scilit |
|---|---|
| Author | Jang, J. W. You, C. R. Kim, C. W. Bae, S. H. Yoon, S. K. Yoo, Y. K. Kim, D. G. Choi, J. Y. |
| Copyright Year | 2010 |
| Description | Journal: Alimentary Pharmacology & Therapeutics Long-term results after downstaging hepatocellular carcinoma (HCC) prior to liver transplantation (LT) remain unknown. To investigate dropouts and post-transplant outcome among patients with downstaged HCC by transarterial chemo-lipiodolization (TACL). Between 2000 and 2007, 386 patients with HCC initially exceeding Milan criteria underwent TACL for tumour downstaging and were consecutively enrolled. Overall, 160 (41.5%) patients achieved successful downstaging of HCC to within Milan criteria. During the follow-up, 82 eventually dropped off the waiting list for LT, with estimated dropout rates at 1, 2 and 5 years of 46.7%, 70.2%, and 87.2%, respectively. The overall post-transplant survival rates at 1, 2 and 5 years were 89.2%, 70.3% and 54.6% and the corresponding rates for recurrence-free survival were 74.7%, 71.8% and 66.3% respectively. Multivariate analysis indentified alpha-fetoprotein (AFP) levels > or = 100 ng/mL at LT (P = 0.003), maximum tumour size > or = 7 cm (P = 0.002) and the lack of complete necrosis by TACL (P = 0.048) as independent predictors of HCC recurrence after LT. Patients with none of these risk factors had an excellent post-transplant outcome, with an 87.5% probability of recurrence-free survival up to 6 years. These long-term results may contribute to the database for optimizing management of LT candidates with downstaged HCC. Based on our data, patients with a maximum tumour size <7 cm who achieve complete necrosis together with AFP levels <100 ng/mL at LT may be the best candidates for LT following downstaging using TACL. |
| Related Links | http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2009.04167.x/pdf |
| Ending Page | 423 |
| Page Count | 9 |
| Starting Page | 415 |
| e-ISSN | 13652036 |
| DOI | 10.1111/j.1365-2036.2009.04167.x |
| Journal | Alimentary Pharmacology & Therapeutics |
| Issue Number | 3 |
| Volume Number | 31 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2010-02-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Alimentary Pharmacology & Therapeutics Gastroenterology and Hepatology Liver Transplant Transplant Population Downsizing Hepatocellular Carcinoma |
| Content Type | Text |
| Resource Type | Article |
