Hepatology|。 Post-liver transplant results in liver cancer patients: Multi-center queue report in the United States

Recently, the latest Global Cancer Burden Report 2020 was released by the International Agency for Research on Cancer (IARC), part of the World Health Organization, which provides a comprehensive analysis of the types of cancers common around the world, the types of major cancers that cause death, and future cancer trends by 2020.
, there will be 19.3 million new types of cancer and nearly 10 million deaths in 2020, according to new cancer data.
almost one in five people will develop cancer in their lifetime, while one in eight men and one in 11 women will die of cancer.
, liver cancer is still one of the 6th most common malignant tumors in China.
cancer deaths ranked 3rd in our country.
the world's most common cancer deaths by 2020. Liver transplantation is a very successful treatment for various types of liver failure, some non-liver failure, and liver cancer (HCC).
it not only removes tumors but also cures the underlying diseases that cause recurrence.
due to the limitation of organ source, the progress of tumor in the waiting process, the high transplant cost is greatly limited.
transplantation has always been the standard of treatment for eligible, non-removable HCC patients.
standard is the most widely used liver cancer liver transplant recipient screening standard in the world.
specifically, there are fewer than 3 tumors with a diameter of no more than 5cm or more and a maximum diameter of no more than 3cm, no large vascular aggression, and no signs of lymph nodes or extra-hepatic metastasis.
study reported that according to the Milan standard HCC patients after 5 years liver transplant survival rate of 75-80%, HCC recurrence rate of 10-15%.
, however, the demand for liver transplants is increasing as HCC morbidity and mortality in the United States rise.
same time, the U.S. Organ Procurement and Transplant Network recently approved the priority of liver transplants for HCC patients who exceed Milan's standards and are demoted through local location therapy.
to this end, a team of experts from UCLA assessed the post-transplant outcomes, downgraded predictive factors, and the effects of local treatment in HCC patients who exceeded the Milan standard in the U.S. Multi-Center HCC Transplant Alliance (20 centers, 2002-2013).
results were published in Hepatology, an authoritative journal of hepatology.
researchers compared clinical pathological characteristics, total lifetime (OS), recurrence (RFS) and HCC recurrence (HCC-R) in patients who met the Milan standard (n-3570) and the Milan standard (n-789).
patients outside the Milan standard were further classified as demoted (DS, n=465), treated with location but not downgraded (LRT-NODS, n=242) or untreated (NOLRT-NODS, n=82).
results showed that the Milan standard (71.3% and 68.2%) had higher OS and RFS after five-year transplants than DS (64.3% and 59.5%), while NODS (n-324; 60.2% and 53.8%) was relatively low.
DS patients had better RFS (60% vs 54%) and lower HCC-R for 5 years (18% vs 32%) than NODS.
further layered by the diameter of the maximum radiation tumor (15.5% for 5-year HCC-R for DS/lt;5cm and 39.1% for NoDS/gt;5cm).
, the multivariable predictors of downgraded treatment include AFP's response to topical treatment, the number and size of tumors, and treatment waiting times > 12 months.
LRT-NoDS had a higher LRT-NoDS HCC-R rate (34.1% vs. 26.1%), even after controlling the counter-probability of clinical pathological variables (HR=2.33) and therapeutic weighted tendency matching (HR=1.82).
addition, in liver transplant patients, the expansion of the standard of liver transplantation is justified by waiting times, AFP response to local treatment and tumor burden leading to good outcomes of liver transplantation.
: Kardashian A, et al. Liver Transplantation Outcomes in a U.S. Multicenter Cohort of 789 Patients with Hepatocellular Carcinoma Presenting Beyond Milan Criteria. Hepatology. 2020 Mar 2. doi: 10.1002/hep.31210.MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Originals" are owned by Mets Medical and are not authorized to reproduce, and any media, website or individual may not reproduce them.
all reprinted articles on this website are for the purpose of transmitting more information and clearly indicate the source and author, and media or individuals who do not wish to be reproduced may contact us and we will delete them immediately.
reproduce content at the same time does not represent the position of this site.
leave a message here