Source:http://linkedlifedata.com/resource/pubmed/id/18688876
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
3
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| pubmed:dateCreated |
2008-9-3
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| pubmed:abstractText |
We previously reported encouraging results of down-staging of hepatocellular carcinoma (HCC) to meet conventional T2 criteria (one lesion 2-5 cm or two to three lesions <3 cm) for orthotopic liver transplantation (OLT) in 30 patients as a test of concept. In this ongoing prospective study, we analyzed longer-term outcome data on HCC down-staging in a larger cohort of 61 patients with tumor stage exceeding T2 criteria who were enrolled between June 2002 and January 2007. Eligibility criteria for down-staging included: (1) one lesion >5 cm and up to 8 cm; (2) two to three lesions with at least one lesion >3 cm and not exceeding 5 cm, with total tumor diameter up to 8 cm; or (3) four to five lesions with none >3 cm, with total tumor diameter up to 8 cm. A minimum observation period of 3 months after down-staging was required before OLT. Tumor down-staging was successful in 43 patients (70.5%). Thirty-five patients (57.4%) had received OLT, including two who had undergone live-donor liver transplantation. Treatment failure was observed in 18 patients (29.5%), primarily due to tumor progression. In the explant of 35 patients who underwent OLT, 13 had complete tumor necrosis, 17 met T2 criteria, and five exceeded T2 criteria. The Kaplan-Meier intention-to-treat survival at 1 and 4 years after down-staging were 87.5% and 69.3%, respectively. The 1-year and 4-year posttransplantation survival rates were 96.2% and 92.1%, respectively. No patient had HCC recurrence after a median posttransplantation follow-up of 25 months. The only factor predicting treatment failure was pretreatment alpha-fetoprotein >1,000 ng/mL. CONCLUSION: Successful down-staging of HCC can be achieved in the majority of carefully selected patients and is associated with excellent posttransplantation outcome.
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| pubmed:grant | |
| pubmed:commentsCorrections | |
| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Sep
|
| pubmed:issn |
1527-3350
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| pubmed:author |
pubmed-author:AscherNancy LNL,
pubmed-author:BassNathan MNM,
pubmed-author:DavernTimothy JTJ3rd,
pubmed-author:FengSandyS,
pubmed-author:FreiseChris ECE,
pubmed-author:HiroseRyutaroR,
pubmed-author:KerlanRobert KRKJr,
pubmed-author:PetersMarionM,
pubmed-author:RobertsJohn PJP,
pubmed-author:TerraultNorahN,
pubmed-author:YaoFrancis YFY
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| pubmed:issnType |
Electronic
|
| pubmed:volume |
48
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
819-27
|
| pubmed:dateRevised |
2010-11-18
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| pubmed:meshHeading |
pubmed-meshheading:18688876-Aged,
pubmed-meshheading:18688876-Carcinoma, Hepatocellular,
pubmed-meshheading:18688876-Cohort Studies,
pubmed-meshheading:18688876-Female,
pubmed-meshheading:18688876-Follow-Up Studies,
pubmed-meshheading:18688876-Guidelines as Topic,
pubmed-meshheading:18688876-Humans,
pubmed-meshheading:18688876-Kaplan-Meier Estimate,
pubmed-meshheading:18688876-Liver Neoplasms,
pubmed-meshheading:18688876-Liver Transplantation,
pubmed-meshheading:18688876-Longitudinal Studies,
pubmed-meshheading:18688876-Male,
pubmed-meshheading:18688876-Middle Aged,
pubmed-meshheading:18688876-Neoplasm Staging,
pubmed-meshheading:18688876-Proportional Hazards Models,
pubmed-meshheading:18688876-Prospective Studies,
pubmed-meshheading:18688876-Treatment Outcome,
pubmed-meshheading:18688876-Waiting Lists
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| pubmed:year |
2008
|
| pubmed:articleTitle |
Excellent outcome following down-staging of hepatocellular carcinoma prior to liver transplantation: an intention-to-treat analysis.
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| pubmed:affiliation |
Department of Medicine, University of California, San Francisco, San Francisco, CA, USA. francis.yao@ucsf.edu
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| pubmed:publicationType |
Journal Article,
Research Support, N.I.H., Extramural
|