TY - JOUR
T1 - Extended criteria for living donor liver transplantation in patients with advanced hepatocellular carcinoma
AU - Choi, H. J.
AU - Kim, D. G.
AU - Na, G. H.
AU - Hong, T. H.
AU - You, Y. K.
PY - 2012/3
Y1 - 2012/3
N2 - Background: The purpose of this study was to evaluate the possibility of expanding the selection criteria in living donor liver transplantation (LDLT) to treat hepatocellular carcinoma (HCC). Methods: From October 2000 to December 2010, we retrospectively analyzed 71 patients who had undergone LDLT beyond the Milan criteria (MC), among the entire cohort of 199 HCC patients. We evaluated the tumor biology as well as overall and disease-free survival (DFS), seeking to identify risk factors for recurrence. The median follow-up was 37 months (range 5124). Results: Among the 71 patients beyond the MC were 18 recurrences and 30 deaths. Their 5-year overall and DFS rates were 52.3% and 67.7%, respectively. On multivariate analysis, tumor diameter, tumor number, and E-S grade significantly influenced overall and DFS. According to our new criteria (size ≤7 cm, number ≤7), 86% of our patients would be included compared with 64% using MC. Five-year DFS and overall survival rates according to our criteria were comparable with the MC: 86.8% and 72.3% versus 86.8% and 73.4%, respectively. Conclusion: Our criteria appear to achieve useful cut-off values beyond the MC.
AB - Background: The purpose of this study was to evaluate the possibility of expanding the selection criteria in living donor liver transplantation (LDLT) to treat hepatocellular carcinoma (HCC). Methods: From October 2000 to December 2010, we retrospectively analyzed 71 patients who had undergone LDLT beyond the Milan criteria (MC), among the entire cohort of 199 HCC patients. We evaluated the tumor biology as well as overall and disease-free survival (DFS), seeking to identify risk factors for recurrence. The median follow-up was 37 months (range 5124). Results: Among the 71 patients beyond the MC were 18 recurrences and 30 deaths. Their 5-year overall and DFS rates were 52.3% and 67.7%, respectively. On multivariate analysis, tumor diameter, tumor number, and E-S grade significantly influenced overall and DFS. According to our new criteria (size ≤7 cm, number ≤7), 86% of our patients would be included compared with 64% using MC. Five-year DFS and overall survival rates according to our criteria were comparable with the MC: 86.8% and 72.3% versus 86.8% and 73.4%, respectively. Conclusion: Our criteria appear to achieve useful cut-off values beyond the MC.
UR - http://www.scopus.com/inward/record.url?scp=84863233869&partnerID=8YFLogxK
U2 - 10.1016/j.transproceed.2012.01.019
DO - 10.1016/j.transproceed.2012.01.019
M3 - Article
C2 - 22410027
AN - SCOPUS:84863233869
SN - 0041-1345
VL - 44
SP - 399
EP - 402
JO - Transplantation Proceedings
JF - Transplantation Proceedings
IS - 2
ER -