Liver Transplantation for Hepatocellular Carcinoma: Impact of Wait Time at a Single Center



Título del documento: Liver Transplantation for Hepatocellular Carcinoma: Impact of Wait Time at a Single Center
Revista: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000407818
ISSN: 1665-2681
Autores: 1
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Instituciones: 1Mayo Clinic, Department of Transplant, Jacksonville, Florida. Estados Unidos de América
2Mayo Clinic, Department of Pathology, Jacksonville, Florida. Estados Unidos de América
3Mayo Clinic, CRISP Program, Jacksonville, Florida. Estados Unidos de América
4Mayo Clinic, Department of Health Sciences Research, Jacksonville, Florida. Estados Unidos de América
Año:
Periodo: May-Jun
Volumen: 16
Número: 3
Paginación: 402-411
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Liver transplantation (LT) provides durable survival for hepatocellular carcinoma (HCC). However, there is continuing debate concerning the impact of wait time and acceptable tumor burden on outcomes after LT. We sought to review outcomes of LT for HCC at a single, large U.S. center, examining the influence of wait time on post-LT outcomes. Material and methods. methods. We methods. reviewed LT for HCC at Mayo Clinic in Florida from 1/1/2003 until 6/30/2014. Follow up was updated through 8/1/ 2015. Results. Results. From 2003-2014, 978 patients were referred for management of HCC. 376 patients were transplanted for presumed Results. HCC within Milan criteria, and the results of these 376 cases were analyzed. The median diagnosis to LT time was 183 days (8 - 4,337), and median transplant list wait time was 62 days (0 - 1815). There was no statistical difference in recurrence-free or overall survival for those with wait time of less than or greater than 180 days from diagnosis of HCC to LT. The most important predictor of long term survival after LT was HCC recurrence (HR: 18.61, p < 0.001). Recurrences of HCC as well as survival were predicted by factors related to tumor biology, including histopathological grade, vascular invasion, and pre-LT serum alpha-fetoprotein levels. Disease recurrence occurred in 13%. The overall 5-year patient survival was 65.8%, while the probability of 5-year recurrence-free survival was 62.2%. Conclusions. Conclusions. In Conclusions. this large, single-center experience with long-term data, factors of tumor biology, but not a longer wait time, were associated with recurrence-free and overall survival
Disciplinas: Medicina
Palabras clave: Cirugía,
Gastroenterología,
Oncología,
Carcinoma hepatocelular,
Trasplante de hígado,
Tiempo de espera,
Carga tumoral
Keyword: Medicine,
Gastroenterology,
Oncology,
Surgery,
Hepatocellular carcinoma,
Liver transplantation,
Waiting time,
Tumor burden
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