Background: To date the selection of the best candidates for liver transplantation (LT) owing to hepatocellular carcinoma (HCC) has been mainly based on tumor morphological characteristics (nodule diameter and number), which have resulted to be independent risk factors for short long-term survival and a high rate of tumor recurrence. Methods: The study cohort included 118 patients among the 166 with HCC transplanted at our unit from January 2000 to December 2007. Patients were classified according to response to locoregional treatments before LT: progressive Group A; complete Group B; partial Group C; stable Group D. Results: The 3-year and 5-year overall survival rates were 65.5% and 48.9% for Group A versus 84.8% and 74.6% for Group BCD (P = 0.01). The 3-year and 5-year disease-free survival rates were 74% and 74% for Group A and 95.7% and 93% for Group BCD (P = 0.007). HCC progression was the only independent risk factor according to Cox regression P = 0.014 - odds ratio 4.4 (1.35-14.3). Conclusion: After aggressive HCC treatment before LT, imaging progression while on the waiting list was a strong predictor of high HCC recurrence rate also in patients who met the Milan criteria. Lack of imaging progression can contribute toward the selection of good transplant candidates for HCC together with the Milan criteria. Copyright © 2012 by Lippincott Williams & Wilkins

DE CARLIS, L., Sandro, S., Giacomoni, A., Slim, A., Lauterio, A., Mangoni, I., et al. (2012). Beyond the Milan criteria: What risks for patients with hepatocellular carcinoma progression before liver transplantation?. JOURNAL OF CLINICAL GASTROENTEROLOGY, 46(1), 78-86 [10.1097/MCG.0b013e31822b36f6].

Beyond the Milan criteria: What risks for patients with hepatocellular carcinoma progression before liver transplantation?

DE CARLIS, LUCIANO GREGORIO
Primo
;
Lauterio, A;
2012

Abstract

Background: To date the selection of the best candidates for liver transplantation (LT) owing to hepatocellular carcinoma (HCC) has been mainly based on tumor morphological characteristics (nodule diameter and number), which have resulted to be independent risk factors for short long-term survival and a high rate of tumor recurrence. Methods: The study cohort included 118 patients among the 166 with HCC transplanted at our unit from January 2000 to December 2007. Patients were classified according to response to locoregional treatments before LT: progressive Group A; complete Group B; partial Group C; stable Group D. Results: The 3-year and 5-year overall survival rates were 65.5% and 48.9% for Group A versus 84.8% and 74.6% for Group BCD (P = 0.01). The 3-year and 5-year disease-free survival rates were 74% and 74% for Group A and 95.7% and 93% for Group BCD (P = 0.007). HCC progression was the only independent risk factor according to Cox regression P = 0.014 - odds ratio 4.4 (1.35-14.3). Conclusion: After aggressive HCC treatment before LT, imaging progression while on the waiting list was a strong predictor of high HCC recurrence rate also in patients who met the Milan criteria. Lack of imaging progression can contribute toward the selection of good transplant candidates for HCC together with the Milan criteria. Copyright © 2012 by Lippincott Williams & Wilkins
Articolo in rivista - Articolo scientifico
Hepatocellular carcinoma; Locoregional treatment; Tumor progression; Adult; Aged; Carcinoma, Hepatocellular; Disease Progression; Disease-Free Survival; Female; Humans; Liver Neoplasms; Liver Transplantation; Male; Middle Aged; Neoplasm Recurrence, Local; Proportional Hazards Models; Retrospective Studies; Risk Factors; Survival Rate; Patient Selection; Gastroenterology
English
2012
46
1
78
86
none
DE CARLIS, L., Sandro, S., Giacomoni, A., Slim, A., Lauterio, A., Mangoni, I., et al. (2012). Beyond the Milan criteria: What risks for patients with hepatocellular carcinoma progression before liver transplantation?. JOURNAL OF CLINICAL GASTROENTEROLOGY, 46(1), 78-86 [10.1097/MCG.0b013e31822b36f6].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/101047
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