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Article: Long-term survival comparison between primary transplant and upfront curative treatment with salvage transplant for early stage hepatocellular carcinoma

TitleLong-term survival comparison between primary transplant and upfront curative treatment with salvage transplant for early stage hepatocellular carcinoma
Authors
KeywordsHepatocellular carcinoma
Primary transplantation
Propensity score matching
Salvage transplantation
Issue Date2019
PublisherElsevier (Singapore) Pte Ltd, Hong Kong Branch. The Journal's web site is located at http://www.elsevier.com/wps/find/journaldescription.cws_home/708511/description#description
Citation
Asian Journal of Surgery, 2019, v. 42 n. 2, p. 433-442 How to Cite?
AbstractBackground: Whether primary liver transplantation (PLT) or upfront curative treatment with salvage liver transplantation (SLT) is a better treatment option for early hepatocellular carcinoma (HCC) is controversial. This study aims to compare the long-term survival starting from the time of primary treatment between the two approaches for early HCC using propensity score matching (PSM) analysis. Methods: From 1995 to 2014, 175 patients with early HCC undergoing either PLT (n = 149) or SLT (n = 26) were retrospectively reviewed in a prospectively collected database. Patients’ demographic data, tumor characteristics, short-term and long-term outcome were compared between two groups after PSM. Results: After matching, the baseline characteristics were comparable between mPLT group (n = 45) and mSLT group (n = 25). The tumor recurrence rate after transplant was significantly higher in mSLT group than mPLT group (28% vs. 15.6%). Calculating from the time of primary treatment, the 1, 3, and 5-year overall survival rates were comparable between mPLT group (97.8%, 91.1% and 86.3%) and mSLT group (100%, 95% and 85%). However, the 1, 3, and 5-year recurrence-free survival rates were significantly better in mPLT group than mSLT group (95.6% vs. 90%, 86.6% vs. 80% and 84.3% vs. 70%). SLT approach and high pre-treatment serum alpha-fetoprotein level (>200 ηg/mL) were poor prognostic factors for recurrence-free survival after transplant. Conclusions: PLT may be a better treatment option for early HCC, whereas SLT approach for HCC should be cautiously considered under the circumstance of organ shortage.
Persistent Identifierhttp://hdl.handle.net/10722/265255
ISSN
2019 Impact Factor: 1.838
2015 SCImago Journal Rankings: 0.427
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorNg, KKC-
dc.contributor.authorCheung, TT-
dc.contributor.authorWong, CLT-
dc.contributor.authorFung, JYY-
dc.contributor.authorDai, WC-
dc.contributor.authorMa, KW-
dc.contributor.authorShe, WH-
dc.contributor.authorLo, CM-
dc.date.accessioned2018-11-20T02:03:04Z-
dc.date.available2018-11-20T02:03:04Z-
dc.date.issued2019-
dc.identifier.citationAsian Journal of Surgery, 2019, v. 42 n. 2, p. 433-442-
dc.identifier.issn1015-9584-
dc.identifier.urihttp://hdl.handle.net/10722/265255-
dc.description.abstractBackground: Whether primary liver transplantation (PLT) or upfront curative treatment with salvage liver transplantation (SLT) is a better treatment option for early hepatocellular carcinoma (HCC) is controversial. This study aims to compare the long-term survival starting from the time of primary treatment between the two approaches for early HCC using propensity score matching (PSM) analysis. Methods: From 1995 to 2014, 175 patients with early HCC undergoing either PLT (n = 149) or SLT (n = 26) were retrospectively reviewed in a prospectively collected database. Patients’ demographic data, tumor characteristics, short-term and long-term outcome were compared between two groups after PSM. Results: After matching, the baseline characteristics were comparable between mPLT group (n = 45) and mSLT group (n = 25). The tumor recurrence rate after transplant was significantly higher in mSLT group than mPLT group (28% vs. 15.6%). Calculating from the time of primary treatment, the 1, 3, and 5-year overall survival rates were comparable between mPLT group (97.8%, 91.1% and 86.3%) and mSLT group (100%, 95% and 85%). However, the 1, 3, and 5-year recurrence-free survival rates were significantly better in mPLT group than mSLT group (95.6% vs. 90%, 86.6% vs. 80% and 84.3% vs. 70%). SLT approach and high pre-treatment serum alpha-fetoprotein level (>200 ηg/mL) were poor prognostic factors for recurrence-free survival after transplant. Conclusions: PLT may be a better treatment option for early HCC, whereas SLT approach for HCC should be cautiously considered under the circumstance of organ shortage.-
dc.languageeng-
dc.publisherElsevier (Singapore) Pte Ltd, Hong Kong Branch. The Journal's web site is located at http://www.elsevier.com/wps/find/journaldescription.cws_home/708511/description#description-
dc.relation.ispartofAsian Journal of Surgery-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectHepatocellular carcinoma-
dc.subjectPrimary transplantation-
dc.subjectPropensity score matching-
dc.subjectSalvage transplantation-
dc.titleLong-term survival comparison between primary transplant and upfront curative treatment with salvage transplant for early stage hepatocellular carcinoma-
dc.typeArticle-
dc.identifier.emailCheung, TT: cheung68@hku.hk-
dc.identifier.emailWong, CLT: wongtcl@hku.hk-
dc.identifier.emailFung, JYY: jfung@hkucc.hku.hk-
dc.identifier.emailDai, WC: daiwc@hku.hk-
dc.identifier.emailShe, WH: brianshe@hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.emailNg, KKC: kkcng@hku.hk-
dc.identifier.authorityCheung, TT=rp02129-
dc.identifier.authorityWong, CLT=rp01679-
dc.identifier.authorityFung, JYY=rp00518-
dc.identifier.authorityLo, CM=rp00412-
dc.identifier.authorityNg, KKC = rp02390-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/j.asjsur.2018.08.008-
dc.identifier.pmid30262437-
dc.identifier.scopuseid_2-s2.0-85053806215-
dc.identifier.hkuros296176-
dc.identifier.hkuros297998-
dc.identifier.volume42-
dc.identifier.issue2-
dc.identifier.spage433-
dc.identifier.epage442-
dc.identifier.isiWOS:000456475200002-
dc.publisher.placeHong Kong-

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