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Liver transplantation is an alternative treatment of hepatocellular carcinoma beyond the Milan criteria |
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| Authors: | Hsiu-Lung Fan Teng-Wei Chen Chung-Bao Hsieh Hsiang-Chun Jan Sheng-Chuan His Chan De-Chuan Jyh-Cherng Yu |
| Institution: | a Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan b Division of General Surgery, Department of Surgery, Cardinal Tien Hospital, Hsintien Taipei Hsien, 23137 Taiwan c Division of General Surgery, Department of Surgery, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, Republic of China |
| Abstract: | BackgroundThe decision to perform liver transplantation (LT) or liver resection (LR) for patients with hepatocellular carcinoma (HCC) who are beyond the Milan criteria remains controversial.MethodsWe 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.ResultsPatients 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).ConclusionsLT may be the better choice for patients with HCC beyond the Milan criteria. |
| Keywords: | Hepatocellular carcinoma Liver resection Liver transplantation Milan criteria Treatment Outcome |
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