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Good longterm survival after primary living donor liver transplantation for solitary hepatocellular carcinomas up to 8 cm in diameter.
- Source :
-
HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2014 Aug; Vol. 16 (8), pp. 749-57. Date of Electronic Publication: 2014 Jan 28. - Publication Year :
- 2014
-
Abstract
- Objectives: There is controversy over whether hepatocellular carcinoma (HCC) should be primarily treated with living donor liver transplantation (LDLT) if liver resection (LR) can be effective. This retrospective study was conducted to compare survival outcomes in patients treated with either modality for solitary HCC measuring ≤8 cm in diameter.<br />Methods: Outcomes in patients with solitary HCC primarily treated by LDLT were analysed. Patients with solitary HCC of similar sizes with or without microvascular invasion primarily treated with LR were selected at a ratio of 6 : 1 for comparison.<br />Results: In-hospital mortality amounted to 0% and 1.3% in the LDLT (n = 50) and LR (n = 300) groups, respectively (P = 0.918). Complication rates were 34% and 20% in the LDLT and LR groups, respectively (P = 0.027). Rates of 1-, 3-, 5- and 10-year overall survival were 98%, 94%, 89% and 83%, respectively, in the LDLT group and 95%, 85%, 76% and 56%, respectively, in the LR group (P = 0.013). Rates of 1-, 3-, 5- and 10-year disease-free survival were 96%, 90%, 87% and 81%, respectively, in the LDLT group and 81%, 64%, 57% and 40%, respectively, in the LR group (P < 0.0001).<br />Conclusions: Living donor liver transplantation surpassed LR in survival outcomes, achieving a 10-year overall survival rate 1.5 times as high and a 10-year disease-free survival rate twice as high as those facilitated by LR. However, it entailed more complications, in addition to the inevitable risks to the donor.<br /> (© 2014 International Hepato-Pancreato-Biliary Association.)
- Subjects :
- Adult
Aged
Carcinoma, Hepatocellular mortality
Carcinoma, Hepatocellular pathology
Disease-Free Survival
Female
Hospital Mortality
Humans
Kaplan-Meier Estimate
Liver Neoplasms mortality
Liver Neoplasms pathology
Liver Transplantation adverse effects
Liver Transplantation mortality
Male
Middle Aged
Postoperative Complications mortality
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Tumor Burden
Young Adult
Carcinoma, Hepatocellular surgery
Hepatectomy adverse effects
Hepatectomy mortality
Liver Neoplasms surgery
Liver Transplantation methods
Living Donors
Subjects
Details
- Language :
- English
- ISSN :
- 1477-2574
- Volume :
- 16
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- HPB : the official journal of the International Hepato Pancreato Biliary Association
- Publication Type :
- Academic Journal
- Accession number :
- 24467735
- Full Text :
- https://doi.org/10.1111/hpb.12212