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- W2771970057 abstract "Background: Milan criteria (MC) are currently the most established selection tool for liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). Patients with HCC beyond MC are not considered for LT in many centers; however, LT may be the only treatment able to prolong survival in these patients with unresectable HCC. The aim of this study was to assess the role of recipient age and tumor biology expressed by DNA-index in the selection of HCC patients for LT. Patients and Methods: Clinicopathological data of 364 patients with HCC who underwent LT in a high-volume transplant center between 1989 and 2010 were evaluated. Overall survival (OS) was analyzed by tumor burden based on MC, patient age and DNA-index. Results: After a median follow-up time of 78 months, the median survival was 100 months. Factors associated with OS in univariate analysis included MC, patient age, DNA-index and α-fetoprotein level. In multivariate analysis, HCC beyond MC, DNA-index ≥1.5, and α-fetoprotein level>200ng/mL independently predicted worse OS. When stratifying patients by both MC and age, patients younger than 60 years with HCC beyond MC had OS comparable to that of older patients within MC (10 year OS 32% vs. 37%, P=.08; Figure 1). Patients<60 years old with HCC beyond MC but a DNA-index<1.5 had excellent OS (Figure 2), comparable to that of patients within MC. Conclusions: Patients younger than 60 years may undergo LT for HCC with favorable outcomes independently from their tumor burden. Additional assessment of tumor biology using DNA-index within this subset of patients can contribute to the selection of liver transplant candidates who may derive the most long-term survival benefit beyond MC.Figure: No Caption available." @default.
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- W2771970057 date "2014-07-01" @default.
- W2771970057 modified "2023-10-14" @default.
- W2771970057 title "Patient and Tumor Biology Predict Survival Beyond the Milan Criteria in Liver Transplantation for Hepatocellular Carcinoma." @default.
- W2771970057 doi "https://doi.org/10.1097/00007890-201407151-02367" @default.
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