Ecoline Tribillon1, Louise Barbier1, Claire Goumard2, Sabine Irtan1, Fabiano Perdigao-Cotta2, François Durand3, Valérie Paradis4, Jacques Belghiti1, Olivier Scatton2, Olivier Soubrane5. 1. Hepato-Biliary and Pancreatic Surgery and Liver Transplantation Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Paris VII University, Clichy, France. 2. Digestive, Hepato-Biliary and Pancreatic Surgery Department, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris VI University, Paris, France. 3. Hepatology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Paris VII University, Clichy, France. 4. Pathology Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Paris VII University, Clichy, France. 5. Hepato-Biliary and Pancreatic Surgery and Liver Transplantation Department, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Paris VII University, Clichy, France. olivier.soubrane@bjn.aphp.fr.
Abstract
INTRODUCTION: The aim of this study was to compare survival outcomes in patients enlisted for liver transplantation following liver resection for hepatocellular carcinoma before or at recurrence. METHODS: All patients enlisted for liver transplantation following liver resection for hepatocellular carcinoma from 1996 to 2013 were included and compared according to their status at the time of enlistment: before (de principe) or at (salvage) recurrence. Primary end-point was survival since resection. RESULTS: One hundred and twenty-one patients were enlisted for liver transplantation following liver resection for hepatocellular carcinoma. Ten patients enlisted for cirrhosis decompensation were excluded from the analysis. Sixty-three patients were enlisted de principe, and 48 for a salvage transplantation. Eleven patients dropped-out. According to per-protocol analysis, the mean diameter of the largest tumor was the only different pathological characteristic of initial resection between groups (31.6 mm in the de principe group versus 48.3 in the salvage, p = 0.017). The 5-year overall survival rate was significantly increased in the de principe group compared to salvage (84.6 versus 74.8%, p = 0.017). In a multivariate analysis, the salvage strategy was the only independent prognostic factor for death (p = 0.040; OR = 2.5 [1.1-5.8]). CONCLUSION: De principe enlistment for liver transplantation following liver resection for hepatocellular carcinoma is associated with greater survival.
INTRODUCTION: The aim of this study was to compare survival outcomes in patients enlisted for liver transplantation following liver resection for hepatocellular carcinoma before or at recurrence. METHODS: All patients enlisted for liver transplantation following liver resection for hepatocellular carcinoma from 1996 to 2013 were included and compared according to their status at the time of enlistment: before (de principe) or at (salvage) recurrence. Primary end-point was survival since resection. RESULTS: One hundred and twenty-one patients were enlisted for liver transplantation following liver resection for hepatocellular carcinoma. Ten patients enlisted for cirrhosis decompensation were excluded from the analysis. Sixty-three patients were enlisted de principe, and 48 for a salvage transplantation. Eleven patients dropped-out. According to per-protocol analysis, the mean diameter of the largest tumor was the only different pathological characteristic of initial resection between groups (31.6 mm in the de principe group versus 48.3 in the salvage, p = 0.017). The 5-year overall survival rate was significantly increased in the de principe group compared to salvage (84.6 versus 74.8%, p = 0.017). In a multivariate analysis, the salvage strategy was the only independent prognostic factor for death (p = 0.040; OR = 2.5 [1.1-5.8]). CONCLUSION: De principe enlistment for liver transplantation following liver resection for hepatocellular carcinoma is associated with greater survival.
Authors: S Jonas; W O Bechstein; T Steinmüller; M Herrmann; C Radke; T Berg; U Settmacher; P Neuhaus Journal: Hepatology Date: 2001-05 Impact factor: 17.425
Authors: Francis Y Yao; Nathan M Bass; Bev Nikolai; Timothy J Davern; Robert Kerlan; Victor Wu; Nancy L Ascher; John P Roberts Journal: Liver Transpl Date: 2002-10 Impact factor: 5.799
Authors: Shimul A Shah; Sean P Cleary; Alice C Wei; Ilun Yang; Bryce R Taylor; Alan W Hemming; Bernard Langer; David R Grant; Paul D Greig; Steven Gallinger Journal: Surgery Date: 2006-11-01 Impact factor: 3.982