A retrospective cohort study regarding the effect of sirolimus-based immunosuppression protocol on the long-term survival of hepatocellular carcinoma patients after liver transplantation.
- Author:
Xiaofei ZHAO
1
;
Shichun LU
2
;
Menglong WANG
;
Jushan WU
;
Dongdong LIN
;
Qingliang GUO
;
Wei LAI
;
Daobing ZENG
;
Chuanyun LI
;
Yuan LIU
;
Libo SUN
;
Dong YAN
;
Ning LI
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Carcinoma, Hepatocellular; drug therapy; mortality; surgery; Female; Humans; Immunosuppressive Agents; therapeutic use; Liver Neoplasms; drug therapy; mortality; surgery; Liver Transplantation; Male; Middle Aged; Neoplasm Recurrence, Local; Retrospective Studies; Sirolimus; therapeutic use; Survival Rate; Tacrolimus; therapeutic use
- From: Chinese Journal of Surgery 2014;52(4):245-248
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the influence of sirolimus on the long-term survival of patients after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).
METHODSClinic data of 165 consecutive patients who underwent OLT for HCC from February 2005 to March 2012 was analyzed retrospectively. Among them, 94 patients were treated with a sirolimus-based immunosuppressive protocol after OLT, while the other 71 patients with a FK506-based protocol. Postoperative survival time, survival, disease-free survival (DFS) and tumor recurrence rates between the two groups were compared.
RESULTSThe 2 groups were comparable in all clinicopathologic parameters. The sirolimus-based group had higher patient survival rates than the control group at 1-year (87% vs. 97%, P = 0.03), 2-year (80% vs. 88%), 3-year (76% vs. 85%) and 5-year (63% vs. 75%). The 1-year, 2-year, 3-year and 5-year recurrence rates were 12% vs. 3%, 17% vs. 9%, 21% vs. 9% (P = 0.04) and 31% vs. 16% (P = 0.03). Early and mid-HCC (I - II stage) of 131 cases (control group 61 cases, sirolimus-based group of 70 patients). The 1-year, 2-year, 3-year and 5-year survival rates were 90% vs. 97% , 80% vs. 90%, 78% vs. 86% and 65% vs. 82% (P = 0.04) and recurrence rates were 10% vs. 3%, 16% vs. 8%, 18% vs. 8% and 29% vs. 11% (P = 0.01).
CONCLUSIONThe sirolimus-based immunosuppressive protocol reduce long-term postoperative recurrence rate and improve the survival rate of patients after OLT for HCC significantly (especially early-mid HCC).