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Conference Paper: Defining Optimal Treatment for Outside Milan Criteria Hepatocellular Carcinoma - A Propensity Score Matched Analysis
Title | Defining Optimal Treatment for Outside Milan Criteria Hepatocellular Carcinoma - A Propensity Score Matched Analysis |
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Authors | |
Issue Date | 2017 |
Citation | The 2017 Joint International Congress of ILTS, ELITA & LICAGE, Prague, Czech Republic, 24-27 May 2017 How to Cite? |
Abstract | Objective: To compare the treatment efficacy of livertransplantation (LT) and liver resection (LR) for hepatocellular carcinomaoutside Milan Criteria (HCC/MC+)
Background: Milan Criteria has been the gold standard forpatient selection in LT, despite high recurrence rate, LR is the only hope ofcure for patients with HCC/MC+. Recent reports demonstrated comparable survivalbetween HCC/MC+ and HCC/MC- after LT. However, study comparing the LT and LRfor HCC/MC+ in the context of propensity score (PS) matched analysis is scarce.
Method: Patients with pathologically confirmed HCC/MC+were recruited from 1990 to 2016. HCC with evidence of major vascular orperitoneal invasion were excluded. PS matching was performed using hepatitis Bstatus, preoperative alpha-fetal protein (AFP) level, tumor size, tumor numberand MELD score. Patients from LT and LR group were matched in 1:2 ratio foranalysis.
Results: There were 847 patients diagnosed withHCC/MC+. After PS matching, 138 patients, 46 from LT and 92 from LR group wereanalyzed. The median MELD and pre-transplant AFP was 9.35 and 41.5ng/mlrespectively. The median tumor number and size were 2 and 5cm respectively. Thefollow-up time was 63 months. There was no significant difference incomplication rate, hospital mortality and hospital stay between the groups. The5-year disease free survival for LT and LR group was 72.3% and 23.3% (P< 0.001)while the 5-year overall survival for LT and LR group was respectively 70% and41.3% (P= 0.004). Tumor number of 5 or above was found to be the only independentfactor affecting overall survival of HCC/MC+ patients in both LT and LR group (P=0.007,OR 1.98, 95%CI 1.21-3.24).
Conclusion: LT is a superior surgical treatment whencompared to LR for patients with HCC/MC+. Tumor nodules 5 or above is associated with 3 times worse in overallsurvival after LT. |
Description | E-Poster |
Persistent Identifier | http://hdl.handle.net/10722/251285 |
DC Field | Value | Language |
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dc.contributor.author | Ma, KW | - |
dc.contributor.author | Chok, KSH | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Cheung, TT | - |
dc.contributor.author | She, WH | - |
dc.contributor.author | Dai, WC | - |
dc.contributor.author | Fung, JYY | - |
dc.contributor.author | Lo, CM | - |
dc.date.accessioned | 2018-02-05T08:07:13Z | - |
dc.date.available | 2018-02-05T08:07:13Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | The 2017 Joint International Congress of ILTS, ELITA & LICAGE, Prague, Czech Republic, 24-27 May 2017 | - |
dc.identifier.uri | http://hdl.handle.net/10722/251285 | - |
dc.description | E-Poster | - |
dc.description.abstract | Objective: To compare the treatment efficacy of livertransplantation (LT) and liver resection (LR) for hepatocellular carcinomaoutside Milan Criteria (HCC/MC+) Background: Milan Criteria has been the gold standard forpatient selection in LT, despite high recurrence rate, LR is the only hope ofcure for patients with HCC/MC+. Recent reports demonstrated comparable survivalbetween HCC/MC+ and HCC/MC- after LT. However, study comparing the LT and LRfor HCC/MC+ in the context of propensity score (PS) matched analysis is scarce. Method: Patients with pathologically confirmed HCC/MC+were recruited from 1990 to 2016. HCC with evidence of major vascular orperitoneal invasion were excluded. PS matching was performed using hepatitis Bstatus, preoperative alpha-fetal protein (AFP) level, tumor size, tumor numberand MELD score. Patients from LT and LR group were matched in 1:2 ratio foranalysis. Results: There were 847 patients diagnosed withHCC/MC+. After PS matching, 138 patients, 46 from LT and 92 from LR group wereanalyzed. The median MELD and pre-transplant AFP was 9.35 and 41.5ng/mlrespectively. The median tumor number and size were 2 and 5cm respectively. Thefollow-up time was 63 months. There was no significant difference incomplication rate, hospital mortality and hospital stay between the groups. The5-year disease free survival for LT and LR group was 72.3% and 23.3% (P< 0.001)while the 5-year overall survival for LT and LR group was respectively 70% and41.3% (P= 0.004). Tumor number of 5 or above was found to be the only independentfactor affecting overall survival of HCC/MC+ patients in both LT and LR group (P=0.007,OR 1.98, 95%CI 1.21-3.24). Conclusion: LT is a superior surgical treatment whencompared to LR for patients with HCC/MC+. Tumor nodules 5 or above is associated with 3 times worse in overallsurvival after LT. | - |
dc.language | eng | - |
dc.relation.ispartof | The 2017 Joint International Congress of ILTS, ELITA & LICAGE | - |
dc.title | Defining Optimal Treatment for Outside Milan Criteria Hepatocellular Carcinoma - A Propensity Score Matched Analysis | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Chok, KSH: chok6275@hku.hk | - |
dc.identifier.email | Chan, ACY: acchan@hku.hk | - |
dc.identifier.email | Cheung, TT: cheung68@hku.hk | - |
dc.identifier.email | She, WH: brianshe@hku.hk | - |
dc.identifier.email | Dai, WC: daiwc@hku.hk | - |
dc.identifier.email | Fung, JYY: jfung@hkucc.hku.hk | - |
dc.identifier.email | Lo, CM: chungmlo@hkucc.hku.hk | - |
dc.identifier.authority | Chok, KSH=rp02110 | - |
dc.identifier.authority | Chan, ACY=rp00310 | - |
dc.identifier.authority | Cheung, TT=rp02129 | - |
dc.identifier.authority | Fung, JYY=rp00518 | - |
dc.identifier.authority | Lo, CM=rp00412 | - |
dc.identifier.hkuros | 284087 | - |
dc.publisher.place | Prague, Czech Republic | - |