Clinical efficacy and prognostic risk factors of salvage liver transplantation, rehepatectomy, and local ablation in the treatment of postoperative recurrence of hepatocellular carcinoma
10.3760/cma.j.cn501113-20210727-00364
- VernacularTitle:补救性肝移植、再次肝切除和局部消融治疗肝癌术后复发的临床疗效及其预后危险因素
- Author:
Peng LIN
1
;
Yuekai YOU
;
Jianyong LIU
;
Fang YANG
;
Qiucheng CAI
;
Yi JIANG
;
Jiajia SHEN
Author Information
1. 福建医科大学福总临床医学院（中国人民解放军联勤保障部队第九○○医院），福州 350025
- Keywords:
Hepatocellular carcinoma;
Salvage liver transplantation;
Repeated hepatectomy;
Local ablation;
Recurrence;
Risk factors
- From:
Chinese Journal of Hepatology
2023;31(2):155-160
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate and analyze the clinical efficacy of salvage liver transplantation (SLT), rehepatectomy (RH), local ablation (LA), and prognostic risk factors in patients with postoperative recurrence of hepatocellular carcinoma.Methods:Clinical data of 145 patients with recurrent liver cancer in the 900th Hospital of the Joint Logistics Support Force of the People's Liberation Army from January 2005 to June 2018 were retrospectively collected. SLT group, RH group, and LA group included 25, 44, and 76 cases, respectively. Follow-up and statistics were recorded on the overall survival rate, relapse-free survival rate, and complications of the three groups of patients at 1, 2, and 3 years after surgery. Univariate and multivariate COX analyses were used to analyze the prognostic risk factors in patients with recurrent HCC.Results:The overall survival rates of 1, 2, and 3 years following surgery in the SLT, RH, and LA groups were 100.0%, 84.0%, 72.0%, 95.5%, 77.3%, 65.9%, 90.8%, 76.3%, and 63.2%, respectively, when the recurrence of liver cancer met the Milan criteria. The overall survival rate did not differ statistically between SLT and RH ( P = 0.303) or between RH and LA ( P = 0.152). There were statistically significant differences in recurrence-free survival between SLT and RH or RH and LA ( P = 0.046). There was no statistically significant difference in the incidence of complications between SLT and RH or RH and LA ( P > 0.017). Age > 65 years was an independent risk factor affecting the overall survival rate in patients with recurrent HCC. Age > 65 years and recurrence time < 24 months were independent risk factors affecting the recurrence-free survival rate in patients with recurrent HCC. Conclusion:SLT is the best treatment option when the recurrence of HCC meets Milan's criteria. RH and LA are the appropriate treatment plans for recurrent HCC when the liver source is limited.
