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| Role of immunosuppression and tumor differentiation in predicting recurrence after liver transplantation for hepatocellular carcinoma： A multicenter study of 412 patients | |
| 引用本文： | Decaens T,Roudot-Thoraval F,Bresson-Hadni S,Meyer C,Gugenheim J,Durand F,Bernard PH,Boillot O,Compagnon P,Calmus Y,Hardwigsen J,Ducerf C,Pageaux GP,Dharancy S,Chazouillères O,Cherqui D,Duvoux C.Role of immunosuppression and tumor differentiation in predicting recurrence after liver transplantation for hepatocellular carcinoma： A multicenter study of 412 patients[J].世界胃肠病学杂志(英文版),2006,12(45):7319-7325. |
| 作者姓名： | Decaens T Roudot-Thoraval F Bresson-Hadni S Meyer C Gugenheim J Durand F Bernard PH Boillot O Compagnon P Calmus Y Hardwigsen J Ducerf C Pageaux GP Dharancy S Chazouillères O Cherqui D Duvoux C |
| 作者单位： | 1. Service d'Hépatologie et de Gastroentérologie, AP-HP, H(o)pital Henri Mondor, Créteil,Unité INSERM 581, France 2. Département de Santé Publique,AP-HP, H(o)pital Henri Mondor, Créteil, France 3. Service d'Hépatologie, H(o)pital Jean Minjoz, Besancon, France 4. Service de Transplantation, H(o)pital autefeuille,Strasbourg, France 5. Service de Chirurgie Digestive, H(o)pital L'Archet 2, Nice, France 6. Service d'Hépatologie, AP-HP, H(o)pital Beauion, Clichy, France 7. Service d'Hépatologie et de Gastroentérologie, H(o)pital Pellegrin, Bordeaux, France 8. Service de Chirurgie Digestive, H(o)pital Edouard Herriot, Lyon, France 9. Service de Chirurgie Digestive, H(o)pital Ponchaillou, Rennes, France 10. Service de Chirurgie Digestive, AP-HP, H(o)pital Cochin, Paris, France 11. Service de Chirurgie Digestive, H(o)pital la Conception, Marseille, France 12. Service de Chirurgie Digestive, H(o)pital de la Croix Rousse, Lyon, France 13. Fédération Médico-Chirurgicale des Maladies de l'Appareil Digestif, H(o)pital Saint-Eloi, Montpellier,France 14. Service d'Hépatologie et de Gastroentérologie, H(o)pital Claude Huriez, Lille, France 15. Service d'Hépatologie, AP-HP, H(o)pital St Antoine, Paris, France 16. Service de Chirurgie Générale et Digestive, APHP, Hopital Henri Mondor, Créteil, France |
| 摘 要： | INTRODUCTION Hepatocellular carcinoma (HCC) is one of the most common neoplasms and its incidence is currently rising worldwide1-3]. HCC usually occurs in cirrhotic livers and less than 30% of patients presenting with HCC are considered candidates for re… |
| 关 键 词： | 免疫抑制 肝细胞癌 肝移植 分化 |
| 收稿时间： | 2006 Apr 21 |
Role of immunosuppression and tumor differentiation in predicting recurrence after liver transplantation for hepatocellular carcinoma: a multicenter study of 412 patients |
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| Decaens Thomas,Roudot-Thoraval Fran?oise,Bresson-Hadni Solange,Meyer Carole,Gugenheim Jean,Durand Francois,Bernard Pierre-Henri,Boillot Olivier,Compagnon Philippe,Calmus Yvon,Hardwigsen Jean,Ducerf Christian,Pageaux Georges-Philippe,Dharancy Sébastien,Chazouillères Olivier,Cherqui Daniel,Duvoux Christophe.Role of immunosuppression and tumor differentiation in predicting recurrence after liver transplantation for hepatocellular carcinoma: a multicenter study of 412 patients[J].World Journal of Gastroenterology,2006,12(45):7319-7325. | |
| Authors: | Decaens Thomas Roudot-Thoraval Françoise Bresson-Hadni Solange Meyer Carole Gugenheim Jean Durand Francois Bernard Pierre-Henri Boillot Olivier Compagnon Philippe Calmus Yvon Hardwigsen Jean Ducerf Christian Pageaux Georges-Philippe Dharancy Sébastien Chazouillères Olivier Cherqui Daniel Duvoux Christophe |
| Institution: | Thomas Decaens Francoise Roudot-Thoraval Solange Bresson-Hadni Carole Meyer Jean Gugenheim Francois Durand Pierre-Henri Bernard Olivier Boillot Philippe Compagnon Yvon Calmus Jean Hardwigsen Christian Ducerf Georges Philippe Pageaux Sébastien Dharancy Olivier Chazouillères Daniel Cherqui Christophe Duvoux |
| Abstract: | AIM: To assess pre-orthotopic liver transplantation (OLT)factors that could be evaluated pre-operatively or controlled post-operatively associated with hepatocellular carcinoma (HCC) recurrence and disease-free survival after liver transplantation (LT).METHODS: Four hundred and twelve patients transplanted for HCC between 1988 and 1998 in 14 French centers, who survived the postoperative period were studied. Kaplan Meier estimates were calculated for 24 variables potentially associated with recurrence of HCC.Uni- and multivariate analyses were conducted to identify independent predictors of recurrence.RESULTS: Overall 5-year disease-free survival was 57.1%. By univariate analysis, variables associated with disease-free survival were: presence of cirrhosis (P =0.001), etiology of liver disease (P = 0.03), α fetoprotein level (＜ 200, 200 to 2000, or ＞ 2000; P ＜ 0.0001), γ-GT activity (N, N to 2N or ＞ 2N; P = 0.02), the number of nodules (1, 2-3 or ≥ 4; P = 0.02), maximal diameter of the largest nodule (＜ 3 cm, 3 to 5 cm or ＞ 5 cm; P ＜0.0001), the sum of the diameter of the nodules (＜ 3cm, 3 to 5 cm, 5 to 10 cm or ＞10 cm; P ＜ 0.0001), bilobar location (P = 0.01), preoperative portal thrombosis (P ＜ 0.0001), peri-operative treatment of the tumor (P = 0.002) and chemoembolization (P = 0.03), tumor differentiation (P = 0.01), initial type of calcineurin inhibitor (P = 0.003), the use of antilymphocyte antibodies (P = 0.02), rejection episodes (P = 0.003)and period of LT (P ＜ 0.0001). By multivariate analysis,6 variables were independently associated with HCC recurrence: maximal diameter of the largest nodule (P ＜0.0001), time of LT (P ＜ 0.0001), tumor differentiation (P ＜ 0.0001), use of anti-lymphocyte antibody (ATG)or anti-CD3 antibody (olr3) (P = 0.005), preoperative portal thrombosis (P = 0.06) and the number of nodules (P = 0.06).CONCLUSION: This study identifies immunosuppression,through the use of ATG or OKT3, as a predictive factor of tumor recurrence, and confirms the prognostic value of tumor differentiation. |
| Keywords: | Immunosuppression Hepatocellularcarcinoma Tumor differentiation Liver transplantation |
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