Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

31 December 2012

Surgical management of hepatocellular carcinoma in Child-Pugh class B cirrhotic patients: Hepatic resection and/or microwave coagulation therapy versus living donor liver transplantation

Noboru HaradaABE, Ken ShirabeC, Yasuharu IkedaA, Daisuke KorenagaD, Kenji TakenakaE, Yoshihiko MaeharaF

DOI: 10.12659/AOT.883689

Ann Transplant 2012; 17(4): 11-20

Abstract

Background: The surgical management of hepatocellular carcinoma (HCC) in cirrhotic patients with Child-Pugh class B remains controversial. The aim of this study was to compare the results of hepatic resection plus microwave coagulation therapy (MCT) versus living donor liver transplantation (LDLT) for HCC in cirrhotic patients with Child-Pugh class B.
Material/Methods: Between January 1998 and June 2008, 30 patients underwent hepatic resection plus MCN and 40 patients underwent LDLT for HCC with Child-Pugh class B. Univariate and multivariate Cox proportional hazard models were established. Kaplan-Meier survival curves were generated, and a log-rank test was performed to compare group survival status.
Results: There was no difference in overall survival after hepatic resection plus MCT (1-, 3-, and 5-year: 86.7%, 70.4%, and 70.4%, respectively) compared with LDLT (1-, 3-, and 5-year: 92.5%, 81.5%, and 72.6%, respectively). Disease-free survival was significantly better after LDLT compared with hepatic resection plus MCT. On multivariate analyses, the des-gamma-carboxy prothrombin (DCP) level of more 300 mAU/mL was an independent risk factor for overall survaival and recurrence of HCC after LDLT. In preoperative Milan criteria met-patients, 5-year overall survival following LDLT was significantly better than that after hepatic resection plus MCT. Incidentally found hepatocellular carcinoma had higher tendency of well differentiated tumor in the explant liver after LDLT.
Conclusions: In preoperative Milan criteria met-cirrhotic patients with Child-Pugh class B, LDLT was associated with longer disease-free and overall survival than hepatic resection plus MCN. LDLT could not be indicated in the patients with DCP level of more 300 mAU/mL.

Keywords: Child-Pugh class B, hepatocellular carcinoma, hepatic resection, living donor liver transplantation,, Milan criteria, des-gamma-carboxy prothrombin

Add Comment 0 Comments

In Press

06 Feb 2024 : Case report  

Successful Sequential Liver and Isolated Intestine Transplantation for Mitochondrial Neurogastrointestinal ...

Ann Transplant In Press; DOI: 10.12659/AOT.941881  

12 Feb 2024 : Original article  

No Prognostic Impact of Graft-to-Recipient Weight Ratio on Hepatocellular Carcinoma Recurrence Following Li...

Ann Transplant In Press; DOI: 10.12659/AOT.942767  

21 Feb 2024 : Original article  

Use of LCP-Tacrolimus (LCPT) in Kidney Transplantation: A Delphi Consensus Survey of Expert Clinicians

Ann Transplant In Press; DOI: 10.12659/AOT.943498  

Most Viewed Current Articles

05 Apr 2022 : Original article  

Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver Transplantation

DOI :10.12659/AOT.935604

Ann Transplant 2022; 27:e935604

12 Jan 2022 : Original article  

Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...

DOI :10.12659/AOT.934738

Ann Transplant 2022; 27:e934738

22 Nov 2022 : Original article  

Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...

DOI :10.12659/AOT.937988

Ann Transplant 2022; 27:e937988

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358