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Hepatic transplantation outcomes for carefully selected cirrhotic patients with hepatocellular carcinoma: experience at a small- to medium-volume centre

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Abstract

Background

Hepatic transplantation outcomes for cirrhotic patients with hepatocellular carcinoma (HCC) at a small- to medium-volume centre are not fully known due to relative novelty of patient selection criteria.

Aim

To determine hepatic transplantation outcomes for HCC at a small- to medium-volume centre.

Patients and methods

Hepatocellular carcinoma patients were listed for transplantation according to the International Guideline and further categorized as those fulfilling or exceeding Milan or University of San Francisco (UCSF) criteria on explanted liver morphology. Outcomes including mortality, retransplantation, and tumour recurrence rate were analysed.

Results

Twenty-six patients had HCC and on explanted liver morphology, Milan and UCSF criteria met 15 and 18 patients, respectively. Patients and graft survival at 3 months, 1 and 5 years were 100, 96, 84, and 88, 84, 77%, respectively. Outcomes favoured Milan criteria but did not reach statistical significance.

Conclusions

Hepatic transplantation for HCC at a small- to medium-volume transplant centre had comparable survival outcomes to high-volume centres.

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References

  1. Llovet JM, Fuster J (1999) Bruix J for the Barcelona Clinic Liver Cancer (BCLC) Group. Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 30:1434–1440. doi:10.1002/hep.510300629

    Article  CAS  PubMed  Google Scholar 

  2. Burix J, Sherman M, Llovet J et al (2001) Clinical management of heatocellular carcinoma. Conclusion of the Barcelona 2000 EASL Conference. J Hepatol 35:421–430. doi:10.1016/S0168-8278(01)00130-1

    Article  Google Scholar 

  3. Cillo U, Vitale A, Bassanello M et al (2004) Liver transplantation for the treatment of moderately or well-differentiated hepatocellular carcinoma. Ann Surg 239:150–159. doi:10.1097/01.sla.0000109146.72827.76

    Article  PubMed  Google Scholar 

  4. Bismuth H, Chiche L, Adam R et al (1993) Liver resection versus transplantation for hepatocellular carcinoma in cirrhotic patients. Ann Surg 218:145–151. doi:10.1097/00000658-199308000-00005

    Article  CAS  PubMed  Google Scholar 

  5. Romani F, Belli LS, Rondinara SF et al (1994) The role of transplantation in small hepatocellular carcinoma complicating cirrhosis of the liver. J Am Coll Surg 178:379–384

    CAS  PubMed  Google Scholar 

  6. Mazzaferro V, Regalia E, Doci R et al (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 334:693–699. doi:10.1056/NEJM199603143341104

    Article  CAS  PubMed  Google Scholar 

  7. Figueras J, Jaurrieta E, Valls C et al (1997) Survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma: a comparative study. Hepatology 25:1485089. doi:10.1002/hep.510250629

    Article  Google Scholar 

  8. Yao FY, Ferrell L, Bass NM et al (2001) Liver transplantation for hepatocellular carcinoma: expansion of tumor size does not adversely impact survival. Hepatology 33:1394–1403. doi:10.1053/jhep.2001.24563

    Article  CAS  PubMed  Google Scholar 

  9. Marsh JW, Dvuorchik I, Bonham A et al (2000) Is the pathologic TNM staging system for patients with hepatoma predictive of outcome? Cancer 88:538–543. doi:10.1002/(SICI)1097-0142(20000201)88:3<538::AID-CNCR7>3.0.CO;2-H

    Article  CAS  PubMed  Google Scholar 

  10. Barbara L, Benzi G, Gaiani S et al (1992) Natural history of small untreated hepatocellular carcinoma in cirrhosis: a multivariate analysis of prognostic factors of tumor growth rate and patient survival. Hepatology 16(1):132–137. doi:10.1002/hep.1840160122

    Article  CAS  PubMed  Google Scholar 

  11. Sheu JC, Sung JL, Chen DS et al (1985) Growth rate of asymptomatic hepatocellular carcinoma and its clinical implications. Gastroenterology 89(2):259–266

    CAS  PubMed  Google Scholar 

  12. Edmondson H, Steiner P (1954) Primary carcinoma of the liver: a study of 100 cases among 48900 necropsies. Cancer 1:462–503. doi:10.1002/1097-0142(195405)7:3<462::AID-CNCR2820070308>3.0.CO;2-E

    Article  Google Scholar 

  13. Kalbfleisch JD, Prentice RL (1997) The statistical analysis of failure time data. Wiley, New York

    Google Scholar 

  14. Llovet JM, Beaugrand M (2003) Hepatocellular carcinoma: present status and future prospects. J Hepatol 38:S136. doi:10.1016/S0168-8278(02)00432-4

    Article  PubMed  Google Scholar 

  15. Freeman RB, Mithoefer A, Ruthazer R et al (2006) Optimizing staging for hepatocellular carcinoma before liver transplantation: a retrospective analysis of the UNOS/OPTN database. Liver Transpl 12:1504–1511. doi:10.1002/lt.20847

    Article  PubMed  Google Scholar 

  16. Santoyo J, Suarez MA, Fernandez-Aguilar JL et al (2005) Liver transplantation results for hepatocellular carcinoma applying strict preoperative selection criteria. Transpl Proc 37:1488–1490. doi:10.1016/j.transproceed.2005.02.059

    Article  CAS  Google Scholar 

  17. Decaens T, Roudot-Thoraval F, Hadni-Bresson S et al (2006) Impact of UCSF criteria according to pre- and post-OLT tumor features: analysis of 479 patients listed for HCC with a short waiting time. Liver Transpl 12:1761–1769. doi:10.1002/lt.20884

    Article  PubMed  Google Scholar 

  18. Qasim A, McCormick A, Tajjudin T et al (2007) Improved survival outcomes for orthotopic liver transplantation. Ir Med J 100(3):389–390

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. St Vincent’s University Hospital, Dublin, Ireland

    A. Qasim, M. B. Zaman, D. Maguire, J. Geoghegan, R. Gibney, N. Nolan, O. Traynor, J. Hegarty & P. A. McCormick

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  1. A. Qasim
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  2. M. B. Zaman
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  3. D. Maguire
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  4. J. Geoghegan
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  5. R. Gibney
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  6. N. Nolan
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  7. O. Traynor
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  8. J. Hegarty
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  9. P. A. McCormick
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Correspondence to A. Qasim.

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Qasim, A., Zaman, M.B., Maguire, D. et al. Hepatic transplantation outcomes for carefully selected cirrhotic patients with hepatocellular carcinoma: experience at a small- to medium-volume centre. Ir J Med Sci 178, 469–472 (2009). https://doi.org/10.1007/s11845-009-0333-5

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  • DOI: https://doi.org/10.1007/s11845-009-0333-5

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