Improved Results of a Surgical Resection for the Recurrence of Hepatocellular Carcinoma After Living Donor Liver Transplantation
Improved Results of a Surgical Resection for the Recurrence of Hepatocellular Carcinoma After Living Donor Liver Transplantation
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DOI：
10.1245/s10434-010-0999-y
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发表时间：
2010-09-01
影响因子：
3.7
通讯作者：
Maehara, Yoshihko
中科院分区：
文献类型：
--
作者：
Taketomi, Akinobu;Fukuhara, Takasuke;Maehara, Yoshihko
目的。本研究旨在分析活体肝移植（LDLT）后肝细胞癌（HCC）复发的临床结果，并评价手术切除治疗这种复发的疗效。在1996年至2007年期间，共有101例成人肝细胞癌LDLT接受者，其中包括17例复发性肝细胞癌。分析的终点是移植时的生存期和复发时的生存期。分析接受者人口统计学、实验室贵重物品和肿瘤特征。对于任何复发的任何药物或手术治疗也被考虑在内。LDLT术后至首次复发的平均时间为12.9个月，首次复发后至死亡的平均时间为12.0个月。单因素分析显示，性别、干扰素治疗、移植后早期肿瘤复发和手术切除的资格都对肿瘤复发生存有有益的影响。手术切除肿瘤复发是我们研究中最重要的变量，因此将患者分为两组：手术治疗组（n = 9）和非手术治疗组（n = 7）。有趣的是，手术组的总生存率明显优于非手术组，并且与未复发的HCC患者的生存率相似。手术治疗可能对LDLT术后复发的HCC患者有帮助，以改善其预后。
Purpose. This study was designed to analyze the clinical outcomes of the recurrence of hepatocellular carcinoma (HCC) after living donor liver transplantation (LDLT) and to evaluate the efficacy of a surgical resection in treating such a recurrence.Methods. A total of 101 adult LDLT recipients with HCC between 1996 and 2007, including 17 who had recurrent HCC, were reviewed. The endpoints analyzed were survival from time of transplant and survival from time of recurrence. Recipient demographics, laboratory valuables, and tumor characteristics were analyzed. Any medical or surgical treatments that had been administered for any recurrence also were considered.Results. The mean duration until the initial recurrence after LDLT and the mean duration until death after the initial recurrence were 12.9 months and 12.0 months, respectively. A univariate analysis showed that gender, interferon therapy, early posttransplant tumor recurrence, and eligibility for a surgical resection all had a beneficial impact on survival from tumor recurrence. A surgical resection of tumor relapse was the most important variable in our study, and therefore the patients were divided into two groups: surgical therapy group (n = 9), and nonsurgical therapy group (n = 7). Interestingly, the overall survival rates of the surgical group were significantly better than those of the nonsurgical group and were similar to that of the patients without HCC recurrence.Conclusions. Surgical therapy might be useful for patients who experience a recurrence of HCC after LDLT to improve their outcome, when such treatment is available.