Predictor of outcome after living donor liver transplantation for patients with hepatocellular carcinoma beyond the Japan criteria.
Japan criteria
alpha‐fetoprotein
des‐gamma‐carboxy prothrombin
hepatocellular carcinoma
living donor liver transplantation
Journal
Annals of gastroenterological surgery
ISSN: 2475-0328
Titre abrégé: Ann Gastroenterol Surg
Pays: Japan
ID NLM: 101718062
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
12
02
2020
revised:
11
03
2020
accepted:
20
03
2020
entrez:
30
7
2020
pubmed:
30
7
2020
medline:
30
7
2020
Statut:
epublish
Résumé
The Japan criteria (JC, maximum tumor size within 5 cm, within five tumor nodules, AFP within 500 ng/mL or within Milan criteria) have been applied to cadaveric liver transplantation (LT) for hepatocellular carcinoma (HCC) and will be used for living donor LT (LDLT) in Japan. The aim of this study was to verify the JC in LDLT and to clarify the risk factor of HCC recurrence and mortality after LDLT beyond the JC. Adult patients who underwent LDLT for end-stage liver disease with HCC until October 2019 were reviewed retrospectively (n = 246). Patients were divided into two groups according to whether they were within JC (n = 203) or beyond JC (n = 43). Recurrence-free or overall survival rates after LDLT were compared. Univariate and multivariate analyses were performed to identify risk factors of HCC recurrence and HCC-related mortality after LDLT for patients beyond the JC. Patients beyond the JC had significantly poorer 5-year recurrence-free (50.3% vs 95.9%, The outcome of LDLT for patients within the JC was favorable. Patients beyond the JC with DCP ≥ 300 mAU/mL might be contraindicated for LDLT.
Sections du résumé
BACKGROUND
BACKGROUND
The Japan criteria (JC, maximum tumor size within 5 cm, within five tumor nodules, AFP within 500 ng/mL or within Milan criteria) have been applied to cadaveric liver transplantation (LT) for hepatocellular carcinoma (HCC) and will be used for living donor LT (LDLT) in Japan. The aim of this study was to verify the JC in LDLT and to clarify the risk factor of HCC recurrence and mortality after LDLT beyond the JC.
PATIENTS AND METHODS
METHODS
Adult patients who underwent LDLT for end-stage liver disease with HCC until October 2019 were reviewed retrospectively (n = 246). Patients were divided into two groups according to whether they were within JC (n = 203) or beyond JC (n = 43). Recurrence-free or overall survival rates after LDLT were compared. Univariate and multivariate analyses were performed to identify risk factors of HCC recurrence and HCC-related mortality after LDLT for patients beyond the JC.
RESULTS
RESULTS
Patients beyond the JC had significantly poorer 5-year recurrence-free (50.3% vs 95.9%,
CONCLUSION
CONCLUSIONS
The outcome of LDLT for patients within the JC was favorable. Patients beyond the JC with DCP ≥ 300 mAU/mL might be contraindicated for LDLT.
Identifiants
pubmed: 32724885
doi: 10.1002/ags3.12335
pii: AGS312335
pmc: PMC7382431
doi:
Types de publication
Journal Article
Langues
eng
Pagination
413-421Informations de copyright
© 2020 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology.
Déclaration de conflit d'intérêts
Funding: This work was partly supported by JSPS KAKEN (grant numbers 15H0579 and 18K08542), and by the Program for Basic and Clinical Research on Hepatitis from the Japan Agency for Medical Research and Development (AMED 18fk0210023h0002). Conflict of Interest: Authors declare no conflict of interests of this article. Author Contributions: Yusuke Yonemura wrote the paper; Tomoharu Yoshizumi designed and performed the study, collected and analyzed the data; Shoichi Inokuchi, Yukiko Kosai‐Fujimoto, Noboru Harada, Shinji Itoh, Takeo Toshima, Kazuki Takeishi and Shohei Yoshiya performed the study and collected the data; Masaki Mori provided critical comments. Ethical Statements: The study protocol was approved by the institutional review board (Approved number 2019‐186).
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