Liver transplantation for unresectable hepatocellular carcinoma in normal livers

被引：42

作者：

Mergental, Hynek ^{[2
]}

Adam, Rene ^{[3
]}

Ericzon, Bo-Goran ^{[4
]}

Kalicinski, Piotr ^{[5
]}

Muehlbacher, Ferninand ^{[6
]}

Hockerstedt, Krister ^{[7
]}

Klempnauer, Juergen L. ^{[8
]}

Friman, Styrbjorn ^{[9
]}

Broelsch, Christoph E. ^{[10
]}

Mantion, Georges ^{[11
]}

Fernandez-Sellez, Carlos ^{[12
]}

van Hoek, Bart ^{[13
]}

Fangmann, Josef ^{[14
]}

Pirenne, Jacques ^{[15
]}

Muiesan, Paolo ^{[16
]}

Koenigsrainer, Alfred ^{[17
]}

Mirza, Darius F. ^{[2
]}

Lerut, Jan ^{[18
]}

Detry, Olivier ^{[19
]}

Le Treut, Yves-Ptrice ^{[20
]}

Mazzaferro, Vincenzo ^{[21
]}

Loehe, Florian ^{[22
]}

Berenguer, Marina ^{[23
]}

Clavien, Pierre-Alain ^{[24
]}

Rogiers, Xavier ^{[25
]}

Belghiti, Jacques ^{[26
]}

Kobori, Laslo ^{[27
]}

Burra, Patrizia ^{[28
]}

Wolf, Philippe ^{[29
]}

Schareck, Wolfgang ^{[30
]}

Pisarski, Przemyslaw ^{[31
]}

Foss, Aksel ^{[32
]}

Filipponi, Franco ^{[33
]}

Krawczyk, Marek ^{[34
]}

Wolff, Martin ^{[35
]}

Langrehr, Jan M. ^{[36
]}

Rolles, Keith ^{[37
]}

Jamieson, Neville ^{[38
]}

Hop, Wim C. J. ^{[39
]}

Porte, Robert J. ^{[1
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Hepatopancreatobiliary Surg & Liver Transpla, NL-9700 RB Groningen, Netherlands

[2] Queen Elizabeth Hosp, Birmingham B15 2TH, W Midlands, England

[3] Univ Paris 11, Hop Paul Brousse, AP HP, Villejuif, France

[4] Karolinska Inst, Stockholm, Sweden

[5] Childrens Mem Hlth Inst, Warsaw, Poland

[6] Med Univ Vienna, Vienna, Austria

[7] Univ Helsinki, Cent Hosp, FIN-00014 Helsinki, Finland

[8] Hannover Med Sch, Hannover, Germany

[9] Sahlgrens Univ Hosp, S-41345 Gothenburg, Sweden

[10] Univ Klinikum Essen, Essen, Germany

[11] Hop Jean Minjoz, Besanscon, France

[12] Univ Juan Canalejo, Med Ctr, La Coruna, Spain

[13] Leiden Univ, Med Ctr, NL-2300 RA Leiden, Netherlands

[14] Univ Klinikum Leipzig, Leipzig, Germany

[15] Univ Ziekenhuizen Leuven, Louvain, Belgium

[16] Kings Coll Hosp London, London, England

[17] Univ Klinikum Tubingen, Tubingen, Germany

[18] Clin Univ St Luc, B-1200 Brussels, Belgium

[19] Univ Hosp, Liege, Belgium

[20] Hop Conception, Marseille, France

[21] Ist Nazl Tumori, I-20133 Milan, Italy

[22] Ludwig Maximilians Univ Hosp Munich, Munich, Germany

[23] Hosp Univ La Fe, Valencia, Spain

[24] Univ Spital Zurich, Zurich, Switzerland

[25] Univ Klinikum Hamburg Eppendorf, Hamburg, Germany

[26] Univ Hop Beaujon, Clichy, France

[27] Semmelweis Univ Hosp, Budapest, Hungary

[28] Fegato Azienda Osped Padova, Ctr Trapianti, Padua, Italy

[29] Hop Univ Hautepierre, Strasbourg, France

[30] Univ Klinikum Rostock, Rostock, Germany

[31] Univ Freiburg Klinikum, Freiburg, Germany

[32] Rigshosp, Oslo Univ Hosp, Oslo, Norway

[33] Univ Pisa, Med Sch Hosp, I-56100 Pisa, Italy

[34] Med Univ Warsaw, Warsaw, Poland

[35] Univ Klinikum Bonn, Bonn, Germany

[36] Charite Campus Virchow Klinikum, Berlin, Germany

[37] Royal Free Hosp, London NW3 2QG, England

[38] Addenbrookes Hosp, Cambridge, England

[39] Erasmus Sch Ctr, Rotterdam, Netherlands

来源：

JOURNAL OF HEPATOLOGY | 2012年 / 57卷 / 02期

关键词：

Hepatocellular carcinoma; Liver transplantation; Non-cirrhotic; Non-fibrotic; Unresectable; Recurrent; Hepatoma; LONG-TERM SURVIVAL; NONCIRRHOTIC LIVER; FIBROLAMELLAR CARCINOMA; RISK-FACTORS; CLINICOPATHOLOGICAL FEATURES; PROGNOSTIC-FACTORS; SURGICAL-TREATMENT; HEPATIC RESECTION; TUMOR RECURRENCE; CANCER;

D O I：

10.1016/j.jhep.2012.03.022

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background & Aims:The role of liver transplantation in the treatment of hepatocellular carcinoma in livers without fibrosis/cirrhosis (NC-HCC) is unclear. We aimed to determine selection criteria for liver transplantation in patients with NC-HCC. Methods: Using the European Liver Transplant Registry, we identified 105 patients who underwent liver transplantation for unresectable NC-HCC. Detailed information about patient, tumor characteristics, and survival was obtained from the transplant centers. Variables associated with survival were identified using univariate and multivariate statistical analyses. Results: Liver transplantation was primary treatment in 62 patients and rescue therapy for intrahepatic recurrences after liver resection in 43. Median number of tumors was 3 (range 1-7) and median tumor size 8 cm (range 0.5-30). One- and 5-year overall and tumor-free survival rates were 84% and 49% and 76% and 43%, respectively. Macrovascular invasion (HR 2.55, 95% CI 1.34 to 4.86), lymph node involvement (HR 2.60, 95% CI 1.28 to 5.28), and time interval between liver resection and transplantation <12 months (HR 2.12, 95% CI 0.96 to 4.67) were independently associated with survival. Five-year survival in patients without macrovascular invasion or lymph node involvement was 59% (95% CI 47-70%). Tumor size was not associated with survival. Conclusions: This is the largest reported series of patients transplanted for NC-HCC. Selection of patients without macrovascular invasion or lymph node involvement, or patients >= 12 months after previous liver resection, can result in 5-year survival rates of 59%. In contrast to HCC in cirrhosis, tumor size is not a predictor of post-transplant survival in NC-HCC. (C) 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

引用

页码：297 / 305

页数：9

共 42 条

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