Liver Transplantation for Hepatocellular Carcinoma.
- Author:
Jang Yeong JEON
1
;
Sung Gyu LEE
;
Young Joo LEE
;
Kwang Min PARK
;
Shin HWANG
;
Ki Hun KIM
;
Chul Soo AHN
;
Sun Hyung JOO
;
Duk Bock MOON
;
Chong Woo CHU
;
Pyung Chul MIN
Author Information
1. Department of Surgery, College of Medicine, Hallym University, Chuncheon, Korea.
- Publication Type:Original Article
- Keywords:
Hepatocellular carcinoma (HCC);
Liver transplantation;
LDLT (living donor liver transplantation);
CDLT (cadaveric donor liver transplantation)
- MeSH:
Cadaver;
Carcinoma, Hepatocellular*;
Chungcheongnam-do;
Disease-Free Survival;
Fibrosis;
Follow-Up Studies;
Hospital Mortality;
Humans;
Liver Diseases;
Liver Transplantation*;
Liver*;
Living Donors;
Medical Records;
Neoplasm Metastasis;
Recurrence;
Survival Rate;
Tissue Donors
- From:Journal of the Korean Surgical Society
2003;64(2):144-152
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Surgery remains the treatment of choice for a hepatocellular carcinoma (HCC) confined within the liver. When there is no underlying liver disease, resection is the preferred option. In cases of HCC with cirrhosis, impaired hepatic reserve often precludes safe resection. Recently, acceptable transplantation outcomes have been shown in selected HCC patients. The aim of this study was to review the results of liver transplantation for HCC at the Asan Medical Center. METHODS: 73 HCC patients were treated by liver transplantation between August 1992 and April 2001. There were 7 in-hospital mortalities. The mean age of the patients was 51 years. The period of the median follow-up was 22 months. By reviewing the patients' medical records, we investigated tumor size, and number, TNM stage, survival rates, and recurrences. Statistical analysis was performed using Statistica 5.1 and SPSS 9.0. RESULTS: Among 67 patients, 8 (12%) developed a tumor recurrence or distant metastasis following the liver transplantation. The 3 year and 5 year survival rate were 88 and 57%, respectively. There were 12 incidentalomas. The 1 year and 3 year disease free survival rates of 54 cases, with the exception of the incidentalomas, were 80 and 50%, respectively. There were no statistically significant differences in the survival rates between the groups, with and without preoperative TACE (P=0.70). Also, there were no statistically significant differences in the survival rates between cadaveric donor liver transplantations (CDLT) and living donor liver transplantations (LDLT). CONCLUSION: We assume that transplantation for HCC, in carefully selected patients, may be the solution to HCC in cirrhotic livers. If the donor safety with a LDLT can be ensured, its application to patients with cirrhosis and early HCC may be a solution to the donor shortage, which could improve the survival of this group of patients.
