In:
Journal of Transplantation, Hindawi Limited, Vol. 2010 ( 2010), p. 1-8
Abstract:
Background . Factors affecting outcomes after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) have been extensively studied, but some of them have only recently been discovered or reassessed. Methods . We analyzed classical and more recently emerging variables with a hypothetical impact on recurrence-free survival (RFS) in a single-center series of 283 patients transplanted for HCC between 1997 and 2009. Results . Five-year patient survival and RFS were 75% and 86%, respectively. Thirty-four (12%) patients had HCC recurrence. Elevated preoperative alpha-fetoprotein (AFP) levels, preoperative treatments of HCC, unfulfilled Milan and up-to-seven criteria at final histology, poor tumor differentiation, and tumor microvascular invasion negatively affected RFS by univariate analysis. Milan and up-to-seven criteria applied preoperatively, and the use of m-TOR inhibitors did not reach statistical significance. Cox's proportional hazard model showed that only elevated AFP levels (Odds ; 95% –5.80; ), preoperative tumor treatments (Odds ; 95% –16.42; ), and microvascular invasion (Odds ; 95% –12.41; ) were predictors of lower RFS. Conclusions . Biological aggressiveness and preoperative tumor treatment, rather than traditional and expanded dimensional criteria, conditioned the outcomes in patients transplanted for HCC.
Type of Medium:
Online Resource
ISSN:
2090-0007
,
2090-0015
Language:
English
Publisher:
Hindawi Limited
Publication Date:
2010
detail.hit.zdb_id:
2503421-2