Clinical outcomes and risk factors of hepatocellular carcinoma treated by liver transplantation: A multi-centre comparison of living donor and deceased donor transplantation
Clinical outcomes and risk factors of hepatocellular carcinoma treated by liver transplantation: A multi-centre comparison of living donor and deceased donor transplantation
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DOI：
10.1016/j.clinre.2015.08.003
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发表时间：
2016-06-01
影响因子：
2.7
通讯作者：
Zheng, Shusen
中科院分区：
文献类型：
--
作者：
Hu, Zhenhua;Qian, Ze;Zheng, Shusen
背景资料：目前，对于肝细胞癌（HCC）的已故供体肝移植（DDLT）和活体供体肝移植（LDLT）的不同结果存在争议。我们的目的是回顾性比较LDLT和DDLT的结果，并分析影响因素。方法：我们比较了总生存率（OS）和无病生存率（DFS）的肝癌患者LDLT（n = 389）和DDLT（n = 6471）从81个中心在10年的时间。采用Kaplan-Meier法计算OS和DFS率。并对整个队列进行单变量和多变量考克斯比例风险回归，以确定预测因子。6860例患者中，LDLT后1年、3年和5年OS率分别为86.79%、70.16%和66.31%，DDLT后分别为74.2%、54.21%和46.97%（P < 0.001）。LDLT后1、3、5年无病生存率分别为78.46%、63.68%、61.63%，DDLT后分别为65.65%、48.61%、41.87%（P < 0.001）。多变量考克斯回归模型确定肝移植（LT）后HCC患者的DFS和OS与肿瘤形态学和生物学密切相关，但与移植物类型无关。结论：关于OS和DFS，与DDLT相比，LDLT没有缺点;肿瘤形态学和生物学可能影响LT的预后。（C）2015 Elsevier Masson SAS。All rights reserved.
Background: The different outcomes of deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) are currently being debated. We aimed to retrospectively compare the outcomes following LDLT and DDLT and to analyse the factors influencing this.Methods: We compared the overall survival (OS) and disease-free survival (DFS) rates of HCC patients after LDLT (n = 389) and DDLT (n = 6471) from 81 centres over a 10-year period. OS and DFS rates were calculated with the Kaplan-Meier method. And univariate and multivariate Cox proportional hazards regressions were performed on the entire cohort to identify predictors.Results: Of 6860 patients, the 1-, 3-, and 5-year OS rates were 86.79%, 70.16%, and 66.31% after LDLT, respectively, and 74.2%, 54.21%, and 46.97% after DDLT, respectively (P < 0.001). The 1-, 3-, and 5-year DFS rates were 78.46%, 63.68%, and 61.63% after LDLT, respectively, and 65.65%, 48.61%, and 41.87% after DDLT, respectively (P < 0.001). The multivariate Cox regression model determined that the DFS and OS of HCC patients post-liver transplantation (LT) were strongly associated with tumour morphology and biology, but not graft type.Conclusions: With regards to OS and DFS, there were no disadvantages to LDLT as compared with DDLT; tumour morphology and biology may affect the prognosis of LT. (C) 2015 Elsevier Masson SAS. All rights reserved.