Comparison of Long-term Outcome According to Preoperative Clinical Course in Patients Undergone Liver Transplantation for Hepatocellular Carcinoma within Milan Criteria.
- Author:
Ji Sun KIM
1
;
Kuhn Uk LEE
;
Woo Young SHIN
;
Young Min JEON
;
Tae Hoon KIM
;
Nam Joon YI
;
Kyung Suk SUH
Author Information
1. Department of Surgery, Seoul National University College of Medicine, Korea. kulee@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Hepatocellular carcinoma;
Liver transplantation;
Neoadjuvant treatment
- MeSH:
Carcinoma, Hepatocellular;
Disease-Free Survival;
Follow-Up Studies;
Humans;
Liver;
Liver Transplantation;
Living Donors;
Neoadjuvant Therapy;
Prognosis
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2009;13(4):235-241
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We wanted to evaluate the influence of preoperative non-surgical treatment and its duration for hepatocellular carcinoma (HCC) patients who underwent liver transplantation (LT). METHODS: We analyzed 75 patients with HCC who underwent living donor liver transplantation from January 1999 to December 2005. The median follow-up was 40.2 months. The patients were divided into the not treated group (26 patients) and non-surgically treated group (49 patients). We compared the overall survival (OS) and disease-free survival (DFS) rates of the 24 not treated patients with that of the 33 treated patients within the Milan criteria. The treated group was divided to 39 short-term (<3 years) treated patients and 10 long-term (> or =3 years) treated patients by the preoperative treatment duration. The OS and DFS rates were analyzed. RESULTS: For 57 patients within the Milan criteria, the 1-, 3- and 5-year OS rates and the 1-, 3- and 5-year DFS rates were 80.0%, 68.5%, 64.8%, 82.0%, 77.2% and 75.1%, respectively. There were no different characteristic between the not treated group and the treated group, except for the mean age and the Child-Turcotte-Pugh score. Compared to the treated group, the OS and DFS rates were slightly better in the not treated group (p=0.053). There were more patients who underwent transcatheter arterial chemoembolization only in the short-term treated group and there were more patients who had microvascular invasion in the long-term treated group. The OS and DFS rates showed no significant difference between the two groups. CONCLUSION: It is possible that LT is a first treatment for HCC patients. If the patients' response to preoperative treatment was good, then their prognosis may be same regardless of the treatment duration.
