| Liver transplantation for hepatocellular carcinoma in New Zealand: a prospective intent-to-treat analysis. | |
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MedLine Citation:
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PMID: 15980906 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Liver transplantation (LT) is potentially curative for early hepatocellular carcinoma (HCC) but time spent on the waiting list exposes patients to the risk of tumour progression prior to transplantation. AIMS: We prospectively evaluated the outcome for New Zealand patients listed for LT with a pre-transplant diagnosis of HCC. METHODS: Patients with 1 to 3 tumours, up to 5 cm in diameter, and no vascular invasion or extra-hepatic disease on imaging, were considered eligible for LT. The results were analysed by intention to treat from the time of listing. RESULTS: Fifty-nine patients were listed with a pre-transplant diagnosis of HCC between February 1998 and June 2004. Ten (17%) were de-listed before LT because of tumour progression, and 9 of 45 (20%) who underwent LT have experienced tumour recurrence up to 59 months post-transplant. For patients listed with a diagnosis of HCC, 5-year actuarial survival was 56.1% from the time of listing. For those listed and transplanted with a diagnosis of HCC, 5-year actuarial survival from the time of transplant was 63.5%. This is significantly worse than the 89.8% 5-year survival for patients transplanted without HCC over the same period (p=0.018) and this difference was entirely due to tumour recurrence. CONCLUSIONS: 37% of patients listed according to our criteria were either de-listed due to tumour progression or experienced recurrence after LT. Based on this experience strategies aimed at preventing waiting list drop out have been adopted, however expansion of tumour-related selection criteria cannot be recommended without a concomitant increase in donor organ availability. |
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Authors:
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Yuhji Marui; John McCall; Edward Gane; Andrew Holden; David Duncan; Mee-Ling Yeong; Kai Chow; Stephen Munn |
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Publication Detail:
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Type: Journal Article Date: 2005-06-24 |
Journal Detail:
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Title: The New Zealand medical journal Volume: 118 ISSN: 1175-8716 ISO Abbreviation: N. Z. Med. J. Publication Date: 2005 Jun |
Date Detail:
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Created Date: 2005-06-27 Completed Date: 2005-10-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401067 Medline TA: N Z Med J Country: New Zealand |
Other Details:
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Languages: eng Pagination: U1532 Citation Subset: IM |
Affiliation:
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New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Carcinoma, Hepatocellular / pathology, secondary, surgery* Female Humans Liver Neoplasms / pathology, surgery* Liver Transplantation / mortality* Male Middle Aged Neoplasm Recurrence, Local / epidemiology Neoplasm Staging New Zealand / epidemiology Prospective Studies Survival Rate Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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