지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2008.9
- 수록면
- 162 - 167 (6page)
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Background: To find the patients who have a significant chance of cure with living donor liver transplantation (LDLT) among the patients suffering with beyond-Milan hepatocellular carcinoma (HCC), we retrospectively analyzed the tumor factors that could affect a good prognosis after LDLT for patients who suffer with beyond Milan HCC.
Methods: Between March 2005 and May 2007, 18 cases of LDLT for beyond Milan HCC were performed. None of the patients had preoperative radiological evidence of vascular invasion. Excluding the 3 cases of in-hospital mortality, we analyzed the survival, the disease-free survival and the prognostic factors for recurrence in 15 beyond Milan HCC patients. The mean follow-up period was 18.8 °± 8.8 months (range: 4-34 months).
Results: The two-year survival and disease-free survival rates after LDLT were 61.7% and 31.1%, respectively, in 15 beyond-Milan patients. Among them, 9 patients had recurrence of HCC during follow-up. The one-year survival rate after tumor recurrence was 55.5%. An alphafetoprotein (AFP) level < 400 ng/mL, Edmonson-Steiner histology grade I and II and the presence of graft rejection were analyzed as the good prognostic factors of disease-free survival after LDLT for beyond-Milan HCC (p < .05). The patients with negative preoperative positron emission tomography (PET) findings (n = 5) showed a better prognosis than the PET-positive patients (n = 10) with statistical significance (p = .05).
Conclusion: Allowing that HCC patients exceed the Milan criteria, we can find the potentially curable candidates for LDLT with using tumor biologic markers such as a serum AFP level < 400 ng/mL, negative PET uptake or low grade histology, as assessed by preoperative needle biopsy. Further investigation is needed to evaluate the relation between graft rejection and tumor recurrence after liver transplantation.
Methods: Between March 2005 and May 2007, 18 cases of LDLT for beyond Milan HCC were performed. None of the patients had preoperative radiological evidence of vascular invasion. Excluding the 3 cases of in-hospital mortality, we analyzed the survival, the disease-free survival and the prognostic factors for recurrence in 15 beyond Milan HCC patients. The mean follow-up period was 18.8 °± 8.8 months (range: 4-34 months).
Results: The two-year survival and disease-free survival rates after LDLT were 61.7% and 31.1%, respectively, in 15 beyond-Milan patients. Among them, 9 patients had recurrence of HCC during follow-up. The one-year survival rate after tumor recurrence was 55.5%. An alphafetoprotein (AFP) level < 400 ng/mL, Edmonson-Steiner histology grade I and II and the presence of graft rejection were analyzed as the good prognostic factors of disease-free survival after LDLT for beyond-Milan HCC (p < .05). The patients with negative preoperative positron emission tomography (PET) findings (n = 5) showed a better prognosis than the PET-positive patients (n = 10) with statistical significance (p = .05).
Conclusion: Allowing that HCC patients exceed the Milan criteria, we can find the potentially curable candidates for LDLT with using tumor biologic markers such as a serum AFP level < 400 ng/mL, negative PET uptake or low grade histology, as assessed by preoperative needle biopsy. Further investigation is needed to evaluate the relation between graft rejection and tumor recurrence after liver transplantation.
목차
서론
방법
결과
고찰
결론
참고문헌
참고문헌 (9)
참고문헌 신청
1. [학술지(정기간행물)] - Mazzaferro V / 1996 / Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis / N Engl J Med 334 : 693 ~
2. [학술지(정기간행물)] - Yao FY / 2001 / Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival / Hepatology 33 : 1394 ~
3. [학술지(정기간행물)] - Sugawara Y / 2007 / Living donor liver transplantation for hepatocellular carcinoma: Tokyo University series / Dig Dis 25 : 310 ~
4. [학술지(정기간행물)] - Takada Y / 2007 / Living donor liver transplantation for patients with HCC exceeding the Milan criteria: a proposal of expanded criteria / Dig Dis 25 : 299 ~
5. [학술지(정기간행물)] - Zavaglia C / 2005 / Predictors of long-term survival after liver transplantation for hepatocellular carcinoma / Am J Gastroenterol 100 : 2708 ~
2. [학술지(정기간행물)] - Yao FY / 2001 / Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival / Hepatology 33 : 1394 ~
3. [학술지(정기간행물)] - Sugawara Y / 2007 / Living donor liver transplantation for hepatocellular carcinoma: Tokyo University series / Dig Dis 25 : 310 ~
4. [학술지(정기간행물)] - Takada Y / 2007 / Living donor liver transplantation for patients with HCC exceeding the Milan criteria: a proposal of expanded criteria / Dig Dis 25 : 299 ~
5. [학술지(정기간행물)] - Zavaglia C / 2005 / Predictors of long-term survival after liver transplantation for hepatocellular carcinoma / Am J Gastroenterol 100 : 2708 ~
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UCI(KEPA) : I410-ECN-0101-2014-514-001254371