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Outcome Comparisons Among the Hangzhou, Chengdu, and UCSF Criteria for Hepatocellular Carcinoma Liver Transplantation after Successful Downstaging Therapies

Journal of Gastrointestinal Surgery volume 17, pages 1116–1122 (2013)Cite this article

Abstract

Background

In Mainland China, many selection criteria for hepatocellular carcinoma (HCC) liver transplantation, such as the Hangzhou, the Chengdu, and the Fudan criteria, have been established. No comparisons have been made among the outcomes using the Hangzhou, Chengdu, and University of California, San Francisco (UCSF) criteria in patients who underwent successful downstaging therapies.

Methods

After successful downstaging therapies, 72 patients met the UCSF criteria, 86 met the Chengdu criteria, and 102 met the Hangzhou criteria. The data on these HCC patients were retrospectively analyzed, and various outcomes, such as survival and the tumor-free survival rate, were compared among the three groups.

Results

No significant differences were observed among the three groups with regard to the downstaging protocols, baseline characteristics, or liver function. However, the patients who met the Hangzhou criteria had significantly larger tumor targets than those who met the Chengdu or UCSF criteria (P < 0.05). The three groups showed similar 1-, 3-, and 5-year survival rates (90.9, 80.0, and 78.6 %, respectively, for the UCSF criteria; 91.6, 81.9, and 75.6 %, respectively, for the Hangzhou criteria; and 91.1, 83.3, and 79.4 %, respectively, for the Chengdu criteria); 1-, 3-, and 5-year tumor-free survival rates (83.3, 77.5, and 75 %, respectively, for the UCSF criteria; 86.3, 78.8, and 75.6 %, respectively, for the Hangzhou criteria; and 87.3, 79.2, and 76.4 %, respectively, for the Chengdu criteria); and 1-, 3-, and 5-year tumor recurrence rates (9.2, 17.5, and 21.4 %, respectively, for the UCSF criteria; 8.4, 16.4, and 20 % for the Hangzhou criteria; and 8.9, 14.6, and 17.6 % for the Chengdu criteria).

Conclusion

Because they have contributed to similar outcomes but to larger HCC patient pools, the Hangzhou criteria for HCC transplantation should be comprehensively accepted in China for HCC patients after successful downstaging therapies.

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Abbreviations

HCC:

Hepatocellular carcinoma

LT:

Liver transplantation

TACE:

Transcatheter arterial chemoembolization

RAF:

Radiofrequency ablation

HIFU:

High-intensity focused ultrasound

AFP:

Alpha-fetoprotein

LDLT:

Living donor liver transplantation

DDLT:

Deceased donor liver transplantation

HBIG:

Hepatitis B immunoglobulin

Anti-HBs:

Hepatitis B surface antigen

BMI:

Body mass index

LD:

Liver disease

TNM:

Tumor–node–metastasis

OLT:

Orthotopic liver transplantation

UNOS:

United Network for Organ Sharing

UCSF:

University of California, San Francisco

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Acknowledgments

Thanks for the language editing service from the American Journal Experts. This study was supported by grants from The National Sciences and Technology Major Project of China (2012ZX10002-016) and (2012ZX10002-017). Thanks for the data from China Liver Transplant Registry (CLTR).

Conflict of interest

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.1

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  1. Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, 610041, China

    Jianyong Lei & Lunan Yan

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  1. Jianyong Lei
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  2. Lunan Yan
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Correspondence to Lunan Yan.

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Lei, J., Yan, L. Outcome Comparisons Among the Hangzhou, Chengdu, and UCSF Criteria for Hepatocellular Carcinoma Liver Transplantation after Successful Downstaging Therapies. J Gastrointest Surg 17, 1116–1122 (2013). https://doi.org/10.1007/s11605-013-2140-6

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Keywords

  • Criteria
  • Liver
  • Transplantation
  • Downstage