Orthotopic liver transplantation for patients with hepatocellular carcinoma complicated by portal vein tumor thrombi. 2004

Xiao Xu, and Shu-Sen Zheng, and Ting-Bo Liang, and Wei-Lin Wang, and Jing Jin, and Yan Shen, and Jian Wu, and Jun Yu
Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

BACKGROUND Orthotopic liver transplantation (OLT) has been the valuable treatment of choice for patients with hepatocellular carcinoma (HCC). As the number of patients with portal vein tumor thrombi (PVTT) increases, most transplant centers become suspicious of the exact effect of the operation which has been accepted as a radical method. This study was designed to evaluate the clinical effects of OLT for patients with HCC associated with PVTT. METHODS The follow-up of 24 patients with HCC complicated by PVTT who had received OLT (transplant group) from January 1999 to March 2003 was compared to that of 27 patients undergoing routine hepatic resection (resection group) and 59 patients without surgical treatment (non-surgical group). RESULTS The perioperative mortality was zero for the transplant group. The 6-month, 1-year, and 2-year overall survival rates were 66.7%, 29.5% and 23.6% for the transplant group, 33.3%, 22.2% and 14.8% for the resection group (P=0.0335), and 42.1%, 24.4% and 4.1% for the non-surgical group, respectively (P=0.0316). The tumor free survival rates of recipients at 6-month, 1-year, and 2-year were 51.5%, 23.2% and zero, respectively. During the period of follow-up, the overall post-transplant intrahepatic recurrence or extrahepatic metastasis rate was 66.7% for the transplant group. CONCLUSIONS OLT is an effective but palliative treatment modality for patients with HCC associated with PVTT followed by a prolonged survival but a poor tumor free survival rate.

UI MeSH Term Description Entries
D008113 Liver Neoplasms Tumors or cancer of the LIVER. Cancer of Liver,Hepatic Cancer,Liver Cancer,Cancer of the Liver,Cancer, Hepatocellular,Hepatic Neoplasms,Hepatocellular Cancer,Neoplasms, Hepatic,Neoplasms, Liver,Cancer, Hepatic,Cancer, Liver,Cancers, Hepatic,Cancers, Hepatocellular,Cancers, Liver,Hepatic Cancers,Hepatic Neoplasm,Hepatocellular Cancers,Liver Cancers,Liver Neoplasm,Neoplasm, Hepatic,Neoplasm, Liver
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D010166 Palliative Care Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed) Palliative Treatment,Palliative Supportive Care,Palliative Surgery,Palliative Therapy,Surgery, Palliative,Therapy, Palliative,Care, Palliative,Palliative Treatments,Supportive Care, Palliative,Treatment, Palliative,Treatments, Palliative
D011169 Portal Vein A short thick vein formed by union of the superior mesenteric vein and the splenic vein. Portal Veins,Vein, Portal,Veins, Portal
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006502 Budd-Chiari Syndrome A condition in which the hepatic venous outflow is obstructed anywhere from the small HEPATIC VEINS to the junction of the INFERIOR VENA CAVA and the RIGHT ATRIUM. Usually the blockage is extrahepatic and caused by blood clots (THROMBUS) or fibrous webs. Parenchymal FIBROSIS is uncommon. Chiari's Syndrome,Hepatic Venous Outflow Obstruction,Hepatic Vein Thrombosis,Budd Chiari Syndrome,Chiari Syndrome,Chiaris Syndrome,Hepatic Vein Thromboses,Thromboses, Hepatic Vein,Thrombosis, Hepatic Vein,Vein Thromboses, Hepatic,Vein Thrombosis, Hepatic
D006528 Carcinoma, Hepatocellular A primary malignant neoplasm of epithelial liver cells. It ranges from a well-differentiated tumor with EPITHELIAL CELLS indistinguishable from normal HEPATOCYTES to a poorly differentiated neoplasm. The cells may be uniform or markedly pleomorphic, or form GIANT CELLS. Several classification schemes have been suggested. Hepatocellular Carcinoma,Hepatoma,Liver Cancer, Adult,Liver Cell Carcinoma,Liver Cell Carcinoma, Adult,Adult Liver Cancer,Adult Liver Cancers,Cancer, Adult Liver,Cancers, Adult Liver,Carcinoma, Liver Cell,Carcinomas, Hepatocellular,Carcinomas, Liver Cell,Cell Carcinoma, Liver,Cell Carcinomas, Liver,Hepatocellular Carcinomas,Hepatomas,Liver Cancers, Adult,Liver Cell Carcinomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D016019 Survival Analysis A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function. Analysis, Survival,Analyses, Survival,Survival Analyses

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