Long-term results of liver transplantation for hepatocellular cancer
S. E. Voskanyan,
E. V. Naidenov,
A. I. Artemiev,
I. Yu. Kolyshev,
D. A. Zabezhinsky,
K. K. Gubarev,
V. S. Rudakov,
M. V. Shabalin,
A. I. Sushkov,
M. V. Popov,
D. S. Svetlakova,
A. P. Maltseva,
M. Muktarzhan,
Z. Sadykhov,
E. V. Vidmer https://doi.org/10.16931/10.16931/1995-5464.2021-2-68-82
Abstract
Aim. To study the long-term results of liver transplantation for hepatocellular carcinoma in accordance with various criteria for selecting patients for surgery.
Materials and methods. The results of 71 liver transplantations for hepatocellular carcinoma have been studied. Long- term survival and disease-free survival have been studied in accordance with various criteria for selecting patients for liver transplantation.
Results. The five-year survival rate was 84.3%, the median survival rate was 47.4 months. Higher overall survival and disease-free survival rates were found in patients after living donor liver transplantation compared to patients after cadaveric liver transplantation. The five-year survival rate for patients within the Milan criteria compared to those beyond the Milan criteria were 92.4% vs 74.1%. The five-year survival rate for patients within the UCSF criteria compared to patients beyond the UCSF criteria were 93.3% vs 68.3%. The five-year survival rate for patients within the Up-to-seven criteria compared to patients beyond the Up-to-seven criteria were 88.4% vs 71.0%. The five-year survival rate for patients within the Hangzhou criteria compared to patients beyond the Hangzhou criteria were 84.4% vs 72.9%. Hepatocellular carcinomas recurrent were in 8.4% of patients in the long-term period of liver transplantation. The five-year disease-free survival rate among all patients was 87.7%. The median disease-free survival rate was 43.2 months. The five-year disease-free survival rate for patients within criteria were from 85.4% (Hangzhou University) to 93.3% (UCSF). The five-year disease-free survival rate for patients beyond criteria were from 68.3% (UCSF) to 74.1% (Milan criteria). A statistically significant relapse rate was observed in patients with a Guerrini coefficient >2.3, regardless of the selection criteria in all study groups of patients.
Conclusion. The optimal prognostic criteria for liver transplantation for patients with hepatocellular carcinoma are the Milan criteria. Some expansion of the Milan criteria show comparable results. In this regard, it can be assumed that the optimal criteria have not been found at present, which requires new ways to search for expansion of the Milan criteria, taking into account the level of AFP, tumor differentiation, etc.
About the Authors
S. E. Voskanyan
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Voskanyan Sergey Eduardovich - Corresponding member of the Russian Academy of Sciences, Doct. of Med. Sci., The Chief of the Surgical Service, Head of the Center for Surgery and Transplantology, Head of the Department of Surgery with courses of Oncosurgery, Endoscopy, Surgical Pathology, Clinical Transplantology and Organ Donation of the Institute of Postgraduate Professional Education
23, Marshal Novikov str., Moscow, 123098
E. V. Naidenov
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Naidenov Evgenii Vladimirovich - Cand. of Med. Sci., Surgeon of the Surgical department №2, Senior Researcher of the Laboratory of New surgical technologies №50, Center for Surgery and Transplantology
23, Marshal Novikov str., Moscow, 123098
A. I. Artemiev
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Artemiev Alexey Igorevich - Cand. of Med. Sci., Head of the Surgical Department №2, Center for Surgery and Transplantology
23, Marshal Novikov str., Moscow, 123098
I. Yu. Kolyshev
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Kolyshev Ilya Yurievich - Cand. of Med. Sci., Head of the Center for new surgical technologies, Head of the Surgical Department №1 of the Center for new surgical technologies
23, Marshal Novikov str., Moscow, 123098
D. A. Zabezhinsky
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Zabezhinsky Dmitry Alexandrovich - Cand. of Med. Sci., Surgeon of the Surgical department №2, Center for Surgery and Transplantology
23, Marshal Novikov str., Moscow, 123098
K. K. Gubarev
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Gubarev Konstantin Konstantinovich - Cand. of Med. Sci., The Chief of the Coordination center of organs and (or) human tissue, Surgery and Transplantation Center
23, Marshal Novikov str., Moscow, 123098
V. S. Rudakov
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Rudakov Vladimir Sergeevich - Cand. of Med. Sci., Surgeon of the Coordination center of organs and (or) human tissue, Surgery and Transplantation Center
23, Marshal Novikov str., Moscow, 123098
M. V. Shabalin
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Shabalin Maxim Vyacheslavovich - Cand. of Med. Sci., Surgeon of the Surgical department №1, Center for New surgical technologies
23, Marshal Novikov str., Moscow, 123098
A. I. Sushkov
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Sushkov Alexandr Igorevich - Cand. of Med. Sci., Head of the Laboratory of new surgical technologies №50
23, Marshal Novikov str., Moscow, 123098
M. V. Popov
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Popov Maxim Vasilievich - endovascular diagnostic and treatment doctor, department of x-ray surgical diagnostic and treatment methods
23, Marshal Novikov str., Moscow, 123098
D. S. Svetlakova
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Svetlakova Daria Sergeevna - Surgeon of the Coordination center of organs and (or) human tissue, Surgery and Transplantation Center
23, Marshal Novikov str., Moscow, 123098
A. P. Maltseva
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Maltseva Anna Pogosovna - Surgeon of the Surgical department №1, Center for New surgical technologies
23, Marshal Novikov str., Moscow, 123098
M. Muktarzhan
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Marlen Muktarzhan - graduate student, Department of Surgery with courses of Oncosurgery, Endoscopy, Surgical Pathology, Clinical Transplantology ang Organ Donation of the Institute of Postgraduate Professional Education
23, Marshal Novikov str., Moscow, 123098
Z. Sadykhov
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Zamin Sadykhov - graduate student, Department of Surgery with courses of Oncosurgery, Endoscopy, Surgical Pathology, Clinical Transplantology ang Organ Donation of the Institute of Postgraduate Professional Education
23, Marshal Novikov str., Moscow, 123098
E. V. Vidmer
State Research Center Burnazyan FMBC of the FMBA of Russia
Russian Federation
Russian Federation
Vidmer Elena Viktorovna - graduate student, Department of Surgery with courses of Oncosurgery, Endoscopy, Surgical Pathology, Clinical Transplantology ang Organ Donation of the Institute of Postgraduate Professional Education
23, Marshal Novikov str., Moscow, 123098
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Voskanyan S.E., Naidenov E.V., Artemiev A.I., Kolyshev I.Yu., Zabezhinsky D.A., Gubarev K.K., Rudakov V.S., Shabalin M.V., Sushkov A.I., Popov M.V., Svetlakova D.S., Maltseva A.P., Muktarzhan M., Sadykhov Z., Vidmer E.V. Long-term results of liver transplantation for hepatocellular cancer. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021;26(2):68-82. (In Russ.) https://doi.org/10.16931/10.16931/1995-5464.2021-2-68-82
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