ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2015
Patient and tumour biology predict survival beyond the Milan criteria in liver transplantation for hepatocellular carcinoma.
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Use of machine learning models for identification of predictors of survival and tumour recurrence in liver transplant recipients with hepatocellular carcinoma.Annals of translational medicine · 2023Article
- Patient Selection for Downstaging of Hepatocellular Carcinoma Prior to Liver Transplantation-Adjusting the Odds?Transplant international : official journal of the European Society for Organ Transplantation · 2022Review
- Sensing Acute Cellular Rejection in Liver Transplant Patients Using Liver-Derived Extracellular Particles: A Prospective, Observational Study.Frontiers in immunology · 2021Observational
- Liver Transplantation for Extended Criteria Hepatocellular Carcinoma Using Stable Response to Locoregional Therapy and Alpha-Fetoprotein as Selection Criteria.Visceral medicine · 2020Article
- Increased Cell-Free DNA Plasma Concentration Following Liver Transplantation Is Linked to Portal Hepatitis and Inferior Survival.Journal of clinical medicine · 2020Article
- A novel machine learning algorithm to predict disease free survival after resection of hepatocellular carcinoma.Annals of translational medicine · 2020Article
- Recurrence of hepatocellular carcinoma following deceased donor liver transplantation: case series.Hepatoma research · 2020Article
- Liver Transplantation and Liver Resection for Cirrhotic Patients with Hepatocellular Carcinoma: Comparison of Long-Term Survivals.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018Article
- [Insight and judgment on recurrence of hepatocellular carcinoma after liver transplantation].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2018Article
- Validity of eleven prognostic scores with respect to intra- and extrahepatic recurrence of hepatocellular carcinoma after liver transplantation.Journal of cancer research and clinical oncology · 2017Article
- Liver resection for intermediate hepatocellular carcinoma.World journal of hepatology · 2016Review
- Impact of age on the prognosis after liver transplantation for patients with hepatocellular carcinoma: a single-center experience.OncoTargets and therapy · 2015Article
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12 authors.
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Abstract
backgroundPatients with hepatocellular carcinoma (HCC) beyond the Milan criteria are not considered for liver transplantation (LT) in many centres; however, LT may be the only treatment able to achieve long-term survival in patients with unresectable HCC. The aim of this study was to assess the role of recipient age and tumour biology expressed by the DNA index in the selection of HCC patients for LT. PATIENTS: Clinicopathological data of 364 patients with HCC who underwent LT between 1989 and 2010 were evaluated. Overall survival (OS) was analysed by patient age, tumour burden based on Milan criteria and the DNA index.
resultsAfter a median follow-up time of 78 months, the median survival was 100 months. Factors associated with OS on univariate analysis included Milan criteria, patient age, hepatitis C infection, alpha-fetoprotein (AFP) level, the DNA index, number of HCC, diameter of HCC, bilobar HCC, microvascular tumour invasion and tumour grading. On multivariate analysis, HCC beyond Milan criteria and the DNA index >1.5 independently predicted a worse OS. When stratifying patients by both age and Milan criteria, patients ≤ 60 years with HCC beyond Milan criteria had an OS comparable to that of patients >60 years within Milan criteria (10-year OS: 33% versus 37%, P = 0.08). Patients ≤ 60 years with HCC beyond Milan criteria but a favourable DNA index ≤ 1.5 achieved excellent long-term outcomes, comparable with those of patients within Milan criteria.
conclusionsPatients ≤ 60 years may undergo LT for HCC with favourable outcomes independently of their tumour burden. Additional assessment of tumour biology, e.g. using the DNA index, especially in this subgroup of patients can support the selection of LT candidates who may derive the most long-term survival benefit, even if Milan criteria are not fulfilled.
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