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Article: Liver transplantation: would it be the best and last chance of cure for hepatocellular carcinoma with major venous invasion?
Title | Liver transplantation: would it be the best and last chance of cure for hepatocellular carcinoma with major venous invasion? |
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Authors | |
Keywords | Liver transplantation (LT) Liver resection (LR) Portal vein Tumour thrombus |
Issue Date | 2021 |
Publisher | AME Publishing Company. The Journal's web site is located at https://hbsn.amegroups.com/ |
Citation | Hepatobiliary Surgery and Nutrition, 2021, v. 10 n. 3, p. 308-314 How to Cite? |
Abstract | Background: Hepatocellular carcinoma (HCC) with portal vein tumour thrombus (PVTT) signifies advanced disease, whether LT confers any survival superiority over resection remains uncertain.
Methods: A propensity score matched (PSM) analysis of liver transplantation (LT) and liver resection (LR) for HCC with PVTT was performed.
Results: A consecutive series of 88 patients who received either LT (10 DDLTs and 3 LDLTs) or LR (n=75) respectively were recruited. Before PSM, the LT group has a higher MELD score (17.3 vs. 7.8, P<0.001), lower serum AFP levels (96 vs. 2,164 ng/mL, P=0.017) and smaller tumour size (4 vs. 10 cm, P<0.001). The 5-year overall survival for LT and LR were 55.4% and 15.9% respectively (P=0.007). After matching for serum AFP levels and tumour size, 1-, 3- and 5-year overall survival for LT were 81 ng/mL, 3.9 cm, 80%, 70% and 70% and the corresponding rates for LR were 1,417 ng/mL, 5.3 cm, 51.8%, 19,6% and 9.8% (P value =0.12, 0.27 and 0.009 respectively).
Conclusions: LT is associated with significantly better oncological outcomes in HCC patients with PVTT involving the lobar or segmental level. A modest expansion of selection criteria to include small HCC with segmental PVTT should be considered. |
Description | Open Access Journal |
Persistent Identifier | http://hdl.handle.net/10722/304708 |
ISSN | 2023 Impact Factor: 6.1 |
DC Field | Value | Language |
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dc.contributor.author | Ma, KW | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Chok, KSH | - |
dc.contributor.author | She, WH | - |
dc.contributor.author | Cheung, TT | - |
dc.contributor.author | Dai, WC | - |
dc.contributor.author | Fung, JYY | - |
dc.contributor.author | Lo, CM | - |
dc.date.accessioned | 2021-10-05T02:34:01Z | - |
dc.date.available | 2021-10-05T02:34:01Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | Hepatobiliary Surgery and Nutrition, 2021, v. 10 n. 3, p. 308-314 | - |
dc.identifier.issn | 2304-3881 | - |
dc.identifier.uri | http://hdl.handle.net/10722/304708 | - |
dc.description | Open Access Journal | - |
dc.description.abstract | Background: Hepatocellular carcinoma (HCC) with portal vein tumour thrombus (PVTT) signifies advanced disease, whether LT confers any survival superiority over resection remains uncertain. Methods: A propensity score matched (PSM) analysis of liver transplantation (LT) and liver resection (LR) for HCC with PVTT was performed. Results: A consecutive series of 88 patients who received either LT (10 DDLTs and 3 LDLTs) or LR (n=75) respectively were recruited. Before PSM, the LT group has a higher MELD score (17.3 vs. 7.8, P<0.001), lower serum AFP levels (96 vs. 2,164 ng/mL, P=0.017) and smaller tumour size (4 vs. 10 cm, P<0.001). The 5-year overall survival for LT and LR were 55.4% and 15.9% respectively (P=0.007). After matching for serum AFP levels and tumour size, 1-, 3- and 5-year overall survival for LT were 81 ng/mL, 3.9 cm, 80%, 70% and 70% and the corresponding rates for LR were 1,417 ng/mL, 5.3 cm, 51.8%, 19,6% and 9.8% (P value =0.12, 0.27 and 0.009 respectively). Conclusions: LT is associated with significantly better oncological outcomes in HCC patients with PVTT involving the lobar or segmental level. A modest expansion of selection criteria to include small HCC with segmental PVTT should be considered. | - |
dc.language | eng | - |
dc.publisher | AME Publishing Company. The Journal's web site is located at https://hbsn.amegroups.com/ | - |
dc.relation.ispartof | Hepatobiliary Surgery and Nutrition | - |
dc.rights | Creative Commons: Attribution 3.0 Hong Kong License | - |
dc.subject | Liver transplantation (LT) | - |
dc.subject | Liver resection (LR) | - |
dc.subject | Portal vein | - |
dc.subject | Tumour thrombus | - |
dc.title | Liver transplantation: would it be the best and last chance of cure for hepatocellular carcinoma with major venous invasion? | - |
dc.type | Article | - |
dc.identifier.email | Chan, ACY: acchan@hku.hk | - |
dc.identifier.email | Chok, KSH: chok6275@hku.hk | - |
dc.identifier.email | Cheung, TT: cheung68@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 | Ma, KW=rp02758 | - |
dc.identifier.authority | Chan, ACY=rp00310 | - |
dc.identifier.authority | Chok, KSH=rp02110 | - |
dc.identifier.authority | Cheung, TT=rp02129 | - |
dc.identifier.authority | Fung, JYY=rp00518 | - |
dc.identifier.authority | Lo, CM=rp00412 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.hkuros | 326536 | - |
dc.identifier.volume | 10 | - |
dc.identifier.issue | 3 | - |
dc.identifier.spage | 308 | - |
dc.identifier.epage | 314 | - |
dc.publisher.place | China | - |