Salvage Liver Transplantation for Recurrent Hepatocellular Carcinoma within UCSF Criteria after Liver Resection 英文参考文献.docVIP
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Salvage Liver Transplantation for Recurrent Hepatocellular Carcinoma within UCSF Criteria after Liver Resection 英文参考文献
SalvageLiverTransplantationforRecurrent
HepatocellularCarcinomawithinUCSFCriteriaafter
LiverResection
FeiLiu,YonggangWei,WentaoWang,KefeiChen,LvnanYan,TianfuWen,JichunZhao,MingqingXu,
BoLi*
DivisionofLiverTransplantation,DepartmentofLiverandVascularSurgery,WestChinaHospital,SichuanUniversity,Chengdu,SichuanProvince,China
Abstract
Background: Salvage liver transplantation (SLT) is restricted to patients who develop hepatocellular carcinoma (HCC)
recurrence within Milan criteria (MC). Little is known about outcomes for SLT in patients with recurrent HCC within
UniversityofCaliforniaSanFrancisco(UCSF)criteriaafterliverresection(LR).
Methods: Between January 2001 and December 2011, 380 patients with HCC meeting UCSF criteria, 200 of which were
resected(LRgroup)fromaperspectiveofSLTincaseofrecurrence,and180directlyunderwentLT(PLT).Wecompared
patientcharacteristics,perioperativeandlong-termoutcomesbetweenSLTandPLTgroups.Wealsoassessedtheoutcome
ofLRandPLTgroups.
Results: Among the 200 patients in LR group, 86 (43%) developed HCC recurrence and 15/86 (17%) of these patients
presentedHCCrecurrenceoutsideUCSFcriteria.Only39ofthe86patientsunderwentSLT,atransplantationrateof45%of
patientswithHCCrecurrence.ComparedwithPLTgroup,LRgroupshowedloweroverallsurvivalrate(P=0.005)andhigher
recurrencerate(P=0.006).AlthoughintraoperativebloodlossandrequiredbloodtransfusionweremorefrequentinSLT
group,theperioperativemortalityandposttransplantcomplicationsweresimilarinSLTandPLTgroups.Theoverallsurvival
andrecurrenceratesdidnotsignificantlydifferbetweenthetwogroups.WhenstratifyingbygrafttypeintheSLTgroup,
overall survival and recurrence rates did not significantly differ between deceased donor LT (DDLT) and living donor LT
(LDLT)groups.InthesubgroupanalysisbyMC,similarresultswereobservedbetweenpatientswithrecurrentHCCmeeting
MCandpatientswithrecurrentHCCbeyondMCbutwithinUCSFcriteria.
Conclusion:OursingleinstitutionexperiencedemonstratedthatpriorhepatectomyandSLTforrecurrentHCCwithinUCSF
c
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