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Article: Long-term survival outcome between living donor and deceased donor liver transplant for hepatocellular carcinoma: intention-to-treat and propensity score matching analyses

TitleLong-term survival outcome between living donor and deceased donor liver transplant for hepatocellular carcinoma: intention-to-treat and propensity score matching analyses
Authors
Issue Date2019
PublisherSpringer for American Society of Breast Surgeons and Society of Surgical Oncology. The Journal's web site is located at http://www.annalssurgicaloncology.org
Citation
Annals of Surgical Oncology, 2019, v. 26 n. 5, p. 1454-1462 How to Cite?
AbstractBackground Previous studies comparing outcomes of hepatocellular carcinoma (HCC) patients after living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) showed conflicting results, and most studies measured survival outcomes from the time of liver transplantation (LT). Method This retrospective study was aimed to evaluate the long-term outcomes of HCC patients listed for LT using intention-to-treat (ITT) and propensity score matching (PSM) analyses. Clinicopathological data were retrieved from a prospectively collected database. Results From 1995 to 2014, 375 HCC patients were listed for LT. ITT-LDLT group had 188 patients, whereas ITT-DDLT group had 187 patients. Twenty-seven patients (14.4%) and 122 patients (65.2%) were delisted from LDLT and DDLT waitlist, respectively. The 1-, 3- and 5-year overall survival rates were significantly better in ITT-LDLT group than ITT-DDLT group (94.1 vs. 77.5%, 81.4 vs. 48.7% and 75.9 vs. 40.8%). High alphafetoprotein (AFP) and ITT-DDLT treatment arm were independent poor prognostic factors affecting overall survival. LDLT group (n = 161) had more young patients, poorer liver function, higher AFP, more tumors outside Milan/UCSF criteria, when compared with DDLT group (n = 85). After PSM, the 1-, 3- and 5-year overall (95.4 vs. 98.5%, 80.0 vs. 92.3% and 73.4 vs. 84.4%) and recurrence-free (87.7% vs. 90.8%, 76.9% vs. 83.1% and 72.2% vs. 81.5%) survival rates were comparable between the matched LDLT and the matched DDLT group, respectively. Conclusion Survival benefit of LDLT was observed for HCC patients with ITT analysis. Despite a more advanced tumor stage, overall and recurrence-free survival rates were comparable between LDLT and DDLT using PSM analysis.
Persistent Identifierhttp://hdl.handle.net/10722/271250
ISSN
2021 Impact Factor: 4.339
2020 SCImago Journal Rankings: 1.764
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, TCL-
dc.contributor.authorNg, KKC-
dc.contributor.authorFung, JYY-
dc.contributor.authorChan, AAC-
dc.contributor.authorCheung, TT-
dc.contributor.authorChok, KSH-
dc.contributor.authorDai, JWC-
dc.contributor.authorLo, CM-
dc.date.accessioned2019-06-24T01:06:15Z-
dc.date.available2019-06-24T01:06:15Z-
dc.date.issued2019-
dc.identifier.citationAnnals of Surgical Oncology, 2019, v. 26 n. 5, p. 1454-1462-
dc.identifier.issn1068-9265-
dc.identifier.urihttp://hdl.handle.net/10722/271250-
dc.description.abstractBackground Previous studies comparing outcomes of hepatocellular carcinoma (HCC) patients after living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) showed conflicting results, and most studies measured survival outcomes from the time of liver transplantation (LT). Method This retrospective study was aimed to evaluate the long-term outcomes of HCC patients listed for LT using intention-to-treat (ITT) and propensity score matching (PSM) analyses. Clinicopathological data were retrieved from a prospectively collected database. Results From 1995 to 2014, 375 HCC patients were listed for LT. ITT-LDLT group had 188 patients, whereas ITT-DDLT group had 187 patients. Twenty-seven patients (14.4%) and 122 patients (65.2%) were delisted from LDLT and DDLT waitlist, respectively. The 1-, 3- and 5-year overall survival rates were significantly better in ITT-LDLT group than ITT-DDLT group (94.1 vs. 77.5%, 81.4 vs. 48.7% and 75.9 vs. 40.8%). High alphafetoprotein (AFP) and ITT-DDLT treatment arm were independent poor prognostic factors affecting overall survival. LDLT group (n = 161) had more young patients, poorer liver function, higher AFP, more tumors outside Milan/UCSF criteria, when compared with DDLT group (n = 85). After PSM, the 1-, 3- and 5-year overall (95.4 vs. 98.5%, 80.0 vs. 92.3% and 73.4 vs. 84.4%) and recurrence-free (87.7% vs. 90.8%, 76.9% vs. 83.1% and 72.2% vs. 81.5%) survival rates were comparable between the matched LDLT and the matched DDLT group, respectively. Conclusion Survival benefit of LDLT was observed for HCC patients with ITT analysis. Despite a more advanced tumor stage, overall and recurrence-free survival rates were comparable between LDLT and DDLT using PSM analysis.-
dc.languageeng-
dc.publisherSpringer for American Society of Breast Surgeons and Society of Surgical Oncology. The Journal's web site is located at http://www.annalssurgicaloncology.org-
dc.relation.ispartofAnnals of Surgical Oncology-
dc.subject.meshabdominal abscess-
dc.subject.meshabdominal bleeding-
dc.subject.meshadult-
dc.subject.meshcancer staging-
dc.subject.meshcancer survival-
dc.titleLong-term survival outcome between living donor and deceased donor liver transplant for hepatocellular carcinoma: intention-to-treat and propensity score matching analyses-
dc.typeArticle-
dc.identifier.emailWong, TCL: wongtcl@hku.hk-
dc.identifier.emailNg, KKC: kkcng@hku.hk-
dc.identifier.emailFung, JYY: jfung@hkucc.hku.hk-
dc.identifier.emailChan, AAC: acchan@hku.hk-
dc.identifier.emailCheung, TT: cheung68@hku.hk-
dc.identifier.emailChok, KSH: chok6275@hku.hk-
dc.identifier.emailDai, JWC: daiwc@hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.authorityWong, TCL=rp01679-
dc.identifier.authorityNg, KKC=rp02390-
dc.identifier.authorityFung, JYY=rp00518-
dc.identifier.authorityChan, AAC=rp00310-
dc.identifier.authorityCheung, TT=rp02129-
dc.identifier.authorityChok, KSH=rp02110-
dc.identifier.authorityLo, CM=rp00412-
dc.description.naturepostprint-
dc.identifier.doi10.1245/s10434-019-07206-0-
dc.identifier.pmid30737669-
dc.identifier.scopuseid_2-s2.0-85060728995-
dc.identifier.hkuros297970-
dc.identifier.volume26-
dc.identifier.issue5-
dc.identifier.spage1454-
dc.identifier.epage1462-
dc.identifier.isiWOS:000464726300045-
dc.publisher.placeUnited States-
dc.identifier.issnl1068-9265-

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