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2016 ; 95
(35
): e4735
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Factors determining long-term outcomes of hepatocellular carcinoma within the
Milan criteria: liver transplantation versus locoregional therapy: A
retrospective cohort study
#MMPMID27583916
Kim JH
; Sinn DH
; Gwak GY
; Choi GS
; Kim JM
; Kwon CHD
; Joh JW
; Kim KY
; Kim K
; Paik YH
; Choi MS
; Lee JH
; Koh KC
; Paik SW
Medicine (Baltimore)
2016[Aug]; 95
(35
): e4735
PMID27583916
show ga
Patients with hepatocellular carcinoma (HCC) satisfying the Milan criteria are
candidates for liver transplantation (LT), but locoregional therapies could be
another options for them.A total of 1859 treatment-naïve HCC patients fulfilling
the Milan criteria were analyzed. Survival tree analysis was performed to
generate survival nodes with similar survival risks in 1729 non-LT group, and
compared with the survival of 130 patients who received LT.Among patients who did
not receive LT, survival tree analysis classified patients into 6 nodes according
to Child-Pugh (CP) score, serum alphafetoprotein (AFP) levels, tumor size, and
age, with different mortality risks (5-year survival rate of 87.3%, 77.5%, 65.8%,
64.7%, 44.0%, and 28.7% for nodes 1-6, respectively; P?0.001). The overall
survival of patients in nodes 1 (CP score 5 with AFP levels <5?ng/mL) and 2 (CP
score 5 with maximal tumor size <2.5?cm) were comparable with that of patients
who received LT (both P?>?0.05), but the survival rates of patients in nodes 3 to
6 were worse than that of LT (P?0.05 for all). In each survival node, survival
differed slightly according to initial treatment modality for patients who did
not receive LT. For patients who received LT, tumor stage at the time of LT was
associated with long-term outcome.Certain groups of non-LT patients showed
survival rates that were similar to the survival rates of LT patients. CP score,
AFP levels, tumor size, and age were baseline factors that can help estimate the
long-term outcomes of non-LT treatment. In addition, tumor stage at the time of
LT and specific initial treatment modality in non-LT patients affected the
long-term outcomes. These factors can help estimate the long-term outcomes of HCC
patients diagnosed within the Milan criteria.