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KMID : 0371320070720050379
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Journal of the Korean Surgical Society
2007 Volume.72 No. 5 p.379 ~ p.386
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Outcome and Risk Factor of Early Recurrence of Hepatocellular Carcinoma after Liver Transplantation and Effect of Pre-transplant Transarterial chemoembolization on Post-transplant Outcome
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Lee Chae-Young
Kim Dong-Goo
Kim Say-June
Moon In-Sung
Lee Myung-Duk
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Abstract
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Purpose: The aims of this study were to find the risk factor and outcomes of patients with an early recurrence (ER) of a hepatocellular carcinoma (HCC) after liver transplantation (LT) and the actual impact of transarterial chemoembolization (TACE) before LT for a HCC on patient survival and HCC recurrence.
Methods: Ninety-eight cases of adult LT, performed between September 1995 and January 2006, were evaluated. The risk factors and prognosis of patient with a HCC after transplantation for an ER, defined as a recurrence within 6 months of transplantation, and the effects of Pre-LT TACE on the disease-free and overall survival rates, as well as the patterns of recurrence after LT, were studied.
Results: A total of 18 patients (18.4%) experienced a HCC recurrence after LT; 10 and 8 patients had early and late recurrences, respectively. From a univariate analysis, the serum alpha-fetoprotein (P=0.003), tumor size (P=0.003), serosa invasion (P=0.000), tumor grade (P=0.011) and vascular invasion (P=0.014) were statistically significant risk factors for an ER. From a multivariate analysis, the presence of serosa invasion of a HCC was the only independent risk factor for an ER (P=0.009; OR=9.407: 95% CI, 1.764∼50.164). There was no difference in the disease free sur-vival and overall survival rates between the TACE and without TACE groups, but the extrahepatic recurrence rate was higher in the TACE than without TACE group.
Conclusion: Serosa invasion by a HCC is independently associated with an ER of HCC after LT. Pre-LT TACE does not influence the disease-free and overall survivals after LT for a HCC. (J Korean Surg Soc 2007;72:379-386)
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KEYWORD
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Hepatocellular carcinoma (HCC), Liver transplantation (LT), Early recurrence (ER), Transarterial chemoembolization (TACE)
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