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Conference Paper: Survival advantage of primary liver transplantation for resectable hepatocellular carcinoma with vascular invasion

TitleSurvival advantage of primary liver transplantation for resectable hepatocellular carcinoma with vascular invasion
Authors
KeywordsMedical sciences
Endocrinology
Issue Date2011
PublisherSpringer New York LLC. The Journal's web site is located at http://www.springer.com/west/home/medicine?SGWID=4-10054-70-173733513-0
Citation
The 21st Conferece of the Asian Pacific Association for the Study of the Liver (APASL 2011), Bangkok, Thailand, 17-20 February 2011., v. 5 n. 1, p. 492, abstract PP38-27 How to Cite?
AbstractBACKGROUND: Vascular invasion is a poor prognostic factor of surgical resection (LR) and liver transplantation (LT) for hepatocellular carcinoma (HCC). Microvascular invasion in the LR specimen is paradoxically considered an indication for LT in some centers. METHODS: From July 2000 to June 2009, adult patients underwent primary LT and LR for HCC were included. Those who received neoadjuvant systemic chemotherapy, targeted therapy, with positive resection margins, with direct or metastatic spread of HCC were also excluded. RESULTS: This study included 95 LT recipients and 620 LR patients. Among the LT recipients 81% were within up-to 7 criteria, 77% within UCSF criteria. Slightly over one quarter (26.3%) had HCC with either macro- or micro-vascular invasion. About three-quarter (73.7%) were of LDLT. 5-year overall survival was 82%. When within up-to-7 criteria (n = 75), the 5-year survival improved to 85.3%. The presence or absence of either macro- or micro-vascular invasion was did not affect survival (5-year overall survival, 88.2 vs. 84.7%, respectively). LT recipients with HCC with vascular invasion had survival comparable to LR patients with HCC without vascular invasion (88.2 vs. 78.9%, p = 0.828) LR patients had 5-year survivals much better than those with vascular invasion who under LR (47.3%). Thus, the significant survival advantage of LT over LR for treatment of HCC with vascular invasion. For the entire cohort of 95 LT recipients and 620 LR patients, the overall 5-year survivals were compromised by: multiple tumors (OR = 1.592, CI = 1.196–2.119, p = 0.001), presence of vascular invasion (OR = 2.332, CI = 1.782–3.052, p < 0.0001) and beyond up-to-7 criteria (OR = 1.526, CI = 1.152–2.023, p = 0.003). Liver transplantation was a favorable factor for survival (OR = 0.410, CI = 0.246–0.684, p = 0.001). CONCLUSIONS: Primary LT for HCC within up-to-7 criteria irrespective of vascular invasion has 5-year survival over 80%. Those with microvascular invasion has the survival advantage of twice as likely a cure.
Descriptionpp. 3-558 of this journal issue contain Abstracts of the 21st APASL Conference 2011
Persistent Identifierhttp://hdl.handle.net/10722/136101
ISSN
2015 Impact Factor: 1.125
2015 SCImago Journal Rankings: 0.669
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, SCen_US
dc.contributor.authorLo, CMen_US
dc.contributor.authorChok, KSHen_US
dc.contributor.authorSharr, WWen_US
dc.contributor.authorChan, ACYen_US
dc.contributor.authorFan, STen_US
dc.date.accessioned2011-07-27T02:02:52Z-
dc.date.available2011-07-27T02:02:52Z-
dc.date.issued2011en_US
dc.identifier.citationThe 21st Conferece of the Asian Pacific Association for the Study of the Liver (APASL 2011), Bangkok, Thailand, 17-20 February 2011., v. 5 n. 1, p. 492, abstract PP38-27en_US
dc.identifier.issn1936-0533-
dc.identifier.urihttp://hdl.handle.net/10722/136101-
dc.descriptionpp. 3-558 of this journal issue contain Abstracts of the 21st APASL Conference 2011-
dc.description.abstractBACKGROUND: Vascular invasion is a poor prognostic factor of surgical resection (LR) and liver transplantation (LT) for hepatocellular carcinoma (HCC). Microvascular invasion in the LR specimen is paradoxically considered an indication for LT in some centers. METHODS: From July 2000 to June 2009, adult patients underwent primary LT and LR for HCC were included. Those who received neoadjuvant systemic chemotherapy, targeted therapy, with positive resection margins, with direct or metastatic spread of HCC were also excluded. RESULTS: This study included 95 LT recipients and 620 LR patients. Among the LT recipients 81% were within up-to 7 criteria, 77% within UCSF criteria. Slightly over one quarter (26.3%) had HCC with either macro- or micro-vascular invasion. About three-quarter (73.7%) were of LDLT. 5-year overall survival was 82%. When within up-to-7 criteria (n = 75), the 5-year survival improved to 85.3%. The presence or absence of either macro- or micro-vascular invasion was did not affect survival (5-year overall survival, 88.2 vs. 84.7%, respectively). LT recipients with HCC with vascular invasion had survival comparable to LR patients with HCC without vascular invasion (88.2 vs. 78.9%, p = 0.828) LR patients had 5-year survivals much better than those with vascular invasion who under LR (47.3%). Thus, the significant survival advantage of LT over LR for treatment of HCC with vascular invasion. For the entire cohort of 95 LT recipients and 620 LR patients, the overall 5-year survivals were compromised by: multiple tumors (OR = 1.592, CI = 1.196–2.119, p = 0.001), presence of vascular invasion (OR = 2.332, CI = 1.782–3.052, p < 0.0001) and beyond up-to-7 criteria (OR = 1.526, CI = 1.152–2.023, p = 0.003). Liver transplantation was a favorable factor for survival (OR = 0.410, CI = 0.246–0.684, p = 0.001). CONCLUSIONS: Primary LT for HCC within up-to-7 criteria irrespective of vascular invasion has 5-year survival over 80%. Those with microvascular invasion has the survival advantage of twice as likely a cure.-
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.springer.com/west/home/medicine?SGWID=4-10054-70-173733513-0-
dc.relation.ispartofHepatology Internationalen_US
dc.rightsThe original publication is available at www.springerlink.com-
dc.subjectMedical sciences-
dc.subjectEndocrinology-
dc.titleSurvival advantage of primary liver transplantation for resectable hepatocellular carcinoma with vascular invasionen_US
dc.typeConference_Paperen_US
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_US
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_US
dc.identifier.emailChan, ACY: acchan@hku.hken_US
dc.identifier.emailFan, ST: stfan@hku.hken_US
dc.identifier.authorityChan, SC=rp01568en_US
dc.identifier.authorityLo, CM=rp00412en_US
dc.identifier.authorityChan, ACY=rp00310en_US
dc.identifier.doi10.1007/s12072-010-9241-z-
dc.identifier.hkuros188361en_US
dc.identifier.volume5en_US
dc.identifier.issue1-
dc.identifier.spage492, abstract PP38en_US
dc.identifier.epage27en_US
dc.identifier.isiWOS:000300105300001-
dc.publisher.placeUnited States-
dc.description.otherThe 21st Conferece of the Asian Pacific Association for the Study of the Liver (APASL 2011), Bangkok, Thailand, 17-20 February 2011., v. 5 n. 1, p. 492, abstract PP38-27-

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