Drop-out rates of patients with hepatocellular cancer listed for liver transplantation: Outcome with chemoembolization
Drop-out rates of patients with hepatocellular cancer listed for liver transplantation: Outcome with chemoembolization
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DOI：
10.1002/lt.20099
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发表时间：
2004-03-01
影响因子：
4.6
通讯作者：
Gores, G
中科院分区：
文献类型：
--
作者：
Maddala, YK;Stadheim, L;Gores, G
肝细胞癌 (HCC) 患者被分配终末期肝病 (MELD) 评分模型，以便获得肝移植 (LT)。公平的政策将把超出可接受的移植标准的 HCC 进展等同于等待名单上的死亡。然而，有关此问题的信息有限。因此，我们的目的是分析等待名单上的 HCC 患者的退出率。 1994 年 1 月至 2001 年 8 月期间，54 名 HCC 患者被列入 LT 名单。患者在 LT 之前接受化疗栓塞，并每三个月评估一次疾病进展情况，直至 LT。首次化疗栓塞时，2 名患者处于 T1 期，45 名患者处于 T2 期，7 名患者处于 T3 期。最终移植的患者的中位时间为 211 天（范围 28-1099 天）。八名患者被从名单中删除。根据 Kaplam-Meier 分析评估，第 6 个月和第 12 个月时，退出等候名单的累积概率分别为 15% 和 25%。最终接受 LT 的患者与中途退出的患者在年龄、性别、初始肿瘤分期或血清 AFP 水平上没有显着差异。总之，HCC 患者新辅助化疗栓塞治疗 6 个月内的退出率为 15%。
Patients with hepatocellular carcinoma (HCC) are assigned model for end stage liver disease (MELD) scores to provide access to liver transplantation (LT). An equitable policy would equate HCC progression beyond acceptable transplantation criteria with death on the waiting list. However, limited information is available regarding this issue. Thus, our aim was to analyze drop-out rates on the waiting list for patients with HCC. Between January 1994 and August 2001, 54 patients with HCC were listed for LT. Patients underwent chemoembolization prior to LT, and were assessed every three months for disease progression until LT. Two patients were stage T1, 45 patients were stage T2, and 7 patients were stage T3 at time of first chemoembolization. Median time was 211 days (range 28-1099 days) for patients that were eventually transplanted. Eight patients were removed from the list. Cumulative probability of drop out on the waiting list, assessed by Kaplam-Meier analysis, was 15% and 25% at 6 and 12 months, respectively. There were no significant differences in age, gender, initial tumor stage, or serum AFP levels in those who eventually underwent LT vs. those who dropped out. In conclusion, neoadjuvant chemoembolization for patients with HCC has a drop-out rate of 15% over 6 months.