Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Comparison of Long-term Outcome According to Preoperative Clinical Course in Patients Undergone Liver Transplantation for Hepatocellular Carcinoma within Milan Criteria

밀란 기준 내의 간세포암 환자의 이식 전 비수술적 치료 유무 및 기간에 따른 이식 후 성적

  • Kim, Ji-Sun (Department of Surgery, Seoul National University College of Medicine) ;
  • Lee, Kuhn-Uk (Department of Surgery, Seoul National University College of Medicine) ;
  • Shin, Woo-Young (Department of Surgery, Seoul National University College of Medicine) ;
  • Jeon, Young-Min (Department of Surgery, Seoul National University College of Medicine) ;
  • Kim, Tae-Hoon (Department of Surgery, Seoul National University College of Medicine) ;
  • Yi, Nam-Joon (Department of Surgery, Seoul National University College of Medicine) ;
  • Suh, Kyung-Suk (Department of Surgery, Seoul National University College of Medicine)
  • 김지선 (서울대학교 의과대학 외과학교실) ;
  • 이건욱 (서울대학교 의과대학 외과학교실) ;
  • 신우영 (서울대학교 의과대학 외과학교실) ;
  • 전영민 (서울대학교 의과대학 외과학교실) ;
  • 김태훈 (서울대학교 의과대학 외과학교실) ;
  • 이남준 (서울대학교 의과대학 외과학교실) ;
  • 서경석 (서울대학교 의과대학 외과학교실)
  • Published : 2009.12.31

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Abstract

Purpose: We wanted to evaluate the influence of preoperative non-surgical treatment and its duration for hepatocellular carcinoma (HCC) patients who underwent liver transplantation (LT). Methods: We analyzed 75 patients with HCC who underwent living donor liver transplantation from January 1999 to December 2005. The median follow-up was 40.2 months. The patients were divided into the not treated group (26 patients) and non-surgically treated group (49 patients). We compared the overall survival (OS) and disease-free survival (DFS) rates of the 24 not treated patients with that of the 33 treated patients within the Milan criteria. The treated group was divided to 39 short-term (<3 years) treated patients and 10 long-term (${\geq}3$ years) treated patients by the preoperative treatment duration. The OS and DFS rates were analyzed. Results: For 57 patients within the Milan criteria, the 1-, 3- and 5-year OS rates and the 1-, 3- and 5-year DFS rates were 80.0%, 68.5%, 64.8%, 82.0%, 77.2% and 75.1%, respectively. There were no different characteristic between the not treated group and the treated group, except for the mean age and the Child-Turcotte-Pugh score. Compared to the treated group, the OS and DFS rates were slightly better in the not treated group (p=0.053). There were more patients who underwent transcatheter arterial chemoembolization only in the short-term treated group and there were more patients who had microvascular invasion in the long-term treated group. The OS and DFS rates showed no significant difference between the two groups. Conclusion: It is possible that LT is a first treatment for HCC patients. If the patients' response to preoperative treatment was good, then their prognosis may be same regardless of the treatment duration.

Keywords

References

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