Survival analysis of patients with stage I and II hepatocellular carcinoma after a liver transplantation or liver resection

Seshadri, Ramanathan; Besur, Siddesh; Niemeyer, David J.; Templin, Megan; McKillop, Iain H.; Swan, Ryan Z.; Martinie, John B.; Russo, Mark W.; Iannitti, David A.

doi:10.1111/hpb.12300

Cited by 34 publications

(22 citation statements)

References 40 publications

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“…As expected, prognosis overall of patients with this stage disease who are treated with more aggressive therapies is good. Transplanted patients had the best survival, and survival for patients following resection, was consistent with prior work [23][24][25][26]. On adjusted analysis, we found that resected and transplanted patients' risk of death at 5 years was more than 50% and 70% decreased when compared to non-surgical therapies, respectively.…”

Section: Treatment Modality and Survivalsupporting

confidence: 88%

Assessment of non‐surgical versus surgical therapy for localized hepatocellular carcinoma

Rajaram

Bilimoria

Salem

et al. 2015

Journal of Surgical Oncology

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Section: Treatment Modality and Survivalsupporting

confidence: 88%

Assessment of non‐surgical versus surgical therapy for localized hepatocellular carcinoma

Rajaram

Bilimoria

Salem

et al. 2015

Journal of Surgical Oncology

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“…In mutual agreement, all publications demonstrate superiority for liver transplantation for the treatment of HCC at the early BCLC stage A [136][137][138] or AJCC stage Ⅰ and Ⅱ HCC [139] . In contrast, liver resection has been demonstrated to yield similar outcome results compared to liver transplantation in patients with incomplete cirrhosis (Ishak score 0-4), thus for these patients, liver transplantation should be avoided in this subgroup of patients [139] . Unfortunately, there are nor studies comparing liver resection and liver transplantation for patients with Child B or Child C cirrhosis.…”

Section: Transplantation Vs Liver Resectionsupporting

confidence: 52%

Hepatocellular carcinoma: Surgeon's view on latest findings and future perspectives

Slotta

Kollmar

Ellenrieder

et al. 2015

WJH

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Hepatocellular carcinoma (HCC) is the most common liver-derived malignancy with a high fatality rate. Risk factors for the development of HCC have been identified and are clearly described. However, due to the lack of tumor-specific symptoms, HCC are diagnosed at progressed tumor stages in most patients, and thus curative therapeutic options are limited. The focus of this review is on surgical therapeutic options which can be offered to patients with HCC with special regard to recent findings, not exclusively focused on surgical therapy, but also to other treatment modalities. Further, potential promising future perspectives for the treatment of HCC are discussed. EPIDEMIOLOGYHepatocellular carcinoma (HCC) is a very common malignant disease with more than 700000 new patients diagnosed per year. Interestingly, the incidence of HCC varies relevantly throughout the world. Whereas HCC is a very common malignant disease in sub-Saharan Africa, and central and south-east Asia with incidence rates of 20-47/100000 habitants, the incidence of REVIEW Submit a

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“…LT has been shown in multiple retrospective studies and a meta-analysis to have superior long term, recurrence-free survival compared to HR. [10–14] However, the scarcity of donor livers is a limiting factor to transplantation in patients who meet criteria. Prolonged waiting times may lead to tumor progression and/or death from liver failure, and the estimated monthly drop-out rate increases with length of time on the waitlist, reaching 5.6% at 12 months.…”

Section: Discussionmentioning

confidence: 99%

MELD score and AST-to-platelet ratio index predict long-term survival in patients with a small hepatocellular carcinoma following non-transplant therapies: a pilot study

Sarkar

DeLeon

2017

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Aim Liver transplantation (LT) is the most effective treatment for long-term survival from hepatocellular carcinoma (HCC); however, insufficient donors limit therapy. We sought to identify characteristics that predicted long-term survival after non-transplant therapies in patients with small HCC. Methods In a database of 1,050 HCC patients, we identified those with single HCC ≤ 3.0 cm, who underwent hepatic resection (HR, n = 16), radiofrequency ablation (RFA, n = 55), or LT (n = 23) with 5-years follow-up. Survival and odds-ratios for survival (OS) after HR/RFA were calculated for MELD score, platelet count, creatinine, albumin, AST/Platelet Ratio Index (APRI), INR, and bilirubin. Results LT patients had 3 and 5-year OS of 82.6% and 73.9% compared to HR/RFA patients with 3 and 5-year OS of 40.8% and 33.8%. The strongest predictors of survival after HR/RFA were MELD < 10 (OR 4.43, 95% CI 1.85–10.58) and APRI ≤ 0.5 (OR 4.25, 95% CI 1.63–11.08). HR/RFA patients with both MELD < 10 and APRI ≤ 0.5 had 3- and 5-year OS of 77.3% and 72.7%. Conclusion Patients with MELD < 10 and APRI ≤ 0.5 who undergo HR/RFA have survival approaching LT. Perhaps patients who meet these criteria can safely undergo non-transplant therapy and donor livers can be allocated to patients with a greater need.

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Survival analysis of patients with stage I and II hepatocellular carcinoma after a liver transplantation or liver resection

Cited by 34 publications

References 40 publications

Assessment of non‐surgical versus surgical therapy for localized hepatocellular carcinoma

Assessment of non‐surgical versus surgical therapy for localized hepatocellular carcinoma

Hepatocellular carcinoma: Surgeon's view on latest findings and future perspectives

MELD score and AST-to-platelet ratio index predict long-term survival in patients with a small hepatocellular carcinoma following non-transplant therapies: a pilot study

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