Salvage liver transplantation for recurrent hepatocellular carcinoma after liver resection: retrospective study of the Milan and Hangzhou criteria.
Salvage liver transplantation for recurrent hepatocellular carcinoma after liver resection: retrospective study of the Milan and Hangzhou criteria.
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DOI：
10.1371/journal.pone.0087222
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Zheng S
中科院分区：
文献类型：
--
作者：
Hu Z;Zhou J;Li Z;Xiang J;Qian Z;Wu J;Zhang M;Zheng S
最近有人提出挽救性肝移植（SLT）用于治疗肝切除术后复发的肝细胞癌；然而，SLT 候选人评估标准尚未得到彻底评估。我们回顾性分析了2004年至2012年在浙江大学第一附属医院肝移植中心接受SLT的53例受者的结局和影响生存的因素。30例受者符合杭州标准，其中16例同时符合米兰标准，其余23例均超过这两个标准。符合米兰或杭州标准的患者1年、3年、5年总生存率和无瘤生存率均优于超出标准的患者。米兰标准以外、杭州标准内的受者，1年、3年总生存率分别为70.1%、70.1%，与米兰标准内受者相似，1年、3年、5年总生存率分别为93.8%%、62.1%、62.1%（P = 0.586）。这两个亚组的无瘤生存率也相似，同一时间间隔内分别为 51.9% 和 51.9% vs. 85.6%、85.6% 和 64.2%（P = 0.054）。 Cox回归分析确定杭州标准（内部与外部，风险比（HR）0.376）和最大肿瘤直径（HR 3.523）是总体生存的独立预测因素。无瘤生存的唯一预测因素是最大肿瘤的直径（HR 22.289）。杭州标准安全地扩大了考生库，在评估SLT考生方面是可行的。这有助于移植实践中供体肝脏的分配。
Salvage liver transplantation (SLT) has recently been proposed for recurrent hepatocellular carcinoma after liver resection; however, criteria for candidate assessment in SLT have not been thoroughly evaluated. We retrospectively analyzed outcomes and factors affecting survival of 53 recipients who received SLT in the Liver Transplantation Center, The First Affiliated Hospital of Zhejiang University between 2004 and 2012. Thirty recipients fulfilled the Hangzhou criteria, of which 16 also fulfilled the Milan criteria, while the remaining 23 exceeded both criteria. The 1-year, 3-year and 5-year overall survival rates and tumor-free survival rates were both superior in patients fulfilling Milan or Hangzhou criteria compared with those exceeding the criteria. For recipients outside Milan criteria but within Hangzhou criteria, the 1-year, 3-year overall survival rates were 70.1%, 70.1%, similar to recipients within Milan criteria, with the 1-year, 3-year and 5-year overall survival of 93.8%%, 62.1% and 62.1% (P = 0.586). The tumor-free survival rates were also similar between these two subgroups, with 51.9% and 51.9% vs. 85.6%, 85.6% and 64.2% during the same time interval, respectively (P = 0.054). Cox regression analysis identified Hangzhou criteria (within vs. outside, hazard ratio (HR) 0.376) and diameter of the largest tumor (HR 3.523) to be independent predictors for overall survival. The only predictor for tumor-free survival was diameter of the largest tumor (HR 22.289). Hangzhou criteria safely expanded the candidate pool and are feasible in assessment of candidates for SLT. This is helpful in donor liver allocation in transplant practice.
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影响因子：
3.7
作者：
Hu Z;Zhou J;Xu X;Li Z;Zhou L;Wu J;Zhang M;Zheng S
通讯作者：
Zheng S
影响因子：
51.1
作者：
Clavien, Pierre-Alain;Lesurtel, Mickael;Bossuyt, Patrick M. M.;Gores, Gregory J.;Langer, Bernard;Perrier, Arnaud
通讯作者：
Perrier, Arnaud
影响因子：
3.7
作者：
Facciuto, Marcelo E.;Koneru, Baburao;Sheiner, Patricia A.
通讯作者：
Sheiner, Patricia A.
影响因子：
158.5
作者：
Mazzaferro, V;Regalia, E;Gennari, L
通讯作者：
Gennari, L
影响因子：
51.1
作者：
Mazzaferro, Vincenzo;Llovet, Josep M.;Hsieh, Chung-Bao
通讯作者：
Hsieh, Chung-Bao