Liver transplantation is an alternative treatment of hepatocellular carcinoma beyond the Milan criteria

Abstract Background The decision to perform liver transplantation (LT) or liver resection (LR) for patients with hepatocellular carcinoma (HCC) who are beyond the Milan criteria remains controversial. Methods We retrospectively analyzed outcome data for 179 patients with HCC beyond the Milan criteri...

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Bibliographic Details
Published in:The American journal of surgery 2010-08, Vol.200 (2), p.252-257
Main Authors: Fan, Hsiu-Lung, M.D, Chen, Teng-Wei, M.D, Hsieh, Chung-Bao, M.D, Jan, Hsiang-Chun, M.D, His, Sheng-Chuan, M.D, De-Chuan, Chan, Chu, Chi-Hong, Ph.D, Yu, Jyh-Cherng, M.D
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular - surgery
Criteria
Data processing
Female
Group dynamics
Hepatectomy
Hepatocellular carcinoma
Humans
Liver
Liver cancer
Liver diseases
Liver Neoplasms - surgery
Liver resection
Liver Transplantation
Liver transplants
Lymphatic system
Male
Medical prognosis
Metastasis
Middle Aged
Milan criteria
Outcome
Patient Selection
Patients
Retrospective Studies
Surgery
Survival
Survival analysis
Tomography
Transplantation
Transplants & implants
Treatment
Treatment Outcome
Tumors
Young Adult
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Summary:Abstract Background The decision to perform liver transplantation (LT) or liver resection (LR) for patients with hepatocellular carcinoma (HCC) who are beyond the Milan criteria remains controversial. Methods We retrospectively analyzed outcome data for 179 patients with HCC beyond the Milan criteria who were treated with LR (n = 135) or LT (n = 44). Univariate and multivariate Cox proportional hazard models were established. Kaplan-Meier survival curves were generated, and a log-rank test was performed to compare group survival status. Results Patients who underwent LR group were significantly older, had a lower TNM stage, and were more likely to have unilateral disease and noncirrhotic liver. Significantly more patients in the LR group had recurrence (53.3% vs 29.5%) or died (61.5% vs 43.2%) than patients in the LT group. Recurrence-free survival rates were 11.9% for the LR group and 61.5% for the LT group. The median overall survival duration showed no statistically difference between the LR group (28.0 months) and the LT group (50.0 months). Conclusions LT may be the better choice for patients with HCC beyond the Milan criteria.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2009.07.049