Impact of tumor size, number of tumors and neutrophil‐to‐lymphocyte ratio in liver transplantation for recurrent hepatocellular carcinoma

Hepatology Research - Tập 43 Số 7 - Trang 709-716 - 2013
Tomoharu Yoshizumi1, Toru Ikegami1, Shohei Yoshiya1, Takashi Motomura1, Yohei Mano1, Jun Muto1, Tetsuo Ikeda1, Yuji Soejima1, Ken Shirabe1, Yoshihiko Maehara1
1Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Tóm tắt

AimHepatocellular carcinoma (HCC) is primarily treated with hepatic resection and/or locoregional therapy. When HCC recurs and further treatment is no longer possible owing to poor liver function, liver transplantation (LT) or living‐donor LT (LDLT) is considered. The aim of this study was to clarify risk factors for tumor recurrence after LDLT in patients with recurrent HCC.MethodsThe study comprised 104 patients who had undergone LDLT because of end‐stage liver disease with recurrent HCC. The recurrence‐free survival rates after the LDLT were calculated. Risk factors for tumor recurrence were identified.ResultsThe 1‐, 3‐ and 5‐year recurrence‐free survival rates were 89.6%, 80.3% and 78.4%, respectively. By univariate analysis, the factors affecting recurrence‐free survival were the sum of the largest tumor size and number of tumors of 8 or more (P < 0.0001), des‐γ‐carboxy prothrombin of more than 300 mAU/mL (P = 0.0001), and a neutrophil‐to‐lymphocyte ratio (NLR) of 4 or more (P = 0.0002), α‐fetoprotein of more than 400 ng/mL (P = 0.0001) and bilobar tumor distribution (P = 0.046). A multivariate analysis identified independent risk factors for post‐LDLT tumor recurrence including the sum of tumor size and number of tumors of 8 or more (P = 0.0004) and an NLR of 4 or more (P = 0.01). The 1‐ and 3‐ year recurrence‐free survival rates in the recipients who had both risk factors were 30.0% and 15.0%, respectively.ConclusionLDLT should not be performed for patients who have both independent risk factors after any treatments for HCC.

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Hepatology Research

Tập 43 Số 7

709-716

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