肝移植治疗肝癌：长期调查显示效果很好

肝胆速递

http://www.ncbi.nlm.nih.gov/pubmed/22608403
J Am Coll Surg. 2012 Jul;215(1):19-28; discussion 28-30. Epub 2012 May 18.

Liver transplantation for hepatocellular carcinoma: long-term results suggest excellent outcomes.
肝移植治疗肝癌：长期调查显示效果很好

肝胆速递：调查回顾了1990年至2011年间约1422肝移植病例，结果显示:1,5,10年生存率分别为88.5%，69.1%和40.5%，仅仅13.3%死于肝癌复发，8%死于肝炎复发。

Doyle MB, Vachharajani N, Maynard E, Shenoy S, Anderson C, Wellen JR, Lowell JA, Chapman WC.
Source

Department of Surgery, Section of Abdominal Transplantation, Washington University School of Medicine, St Louis, MO 63110, USA.
Abstract
BACKGROUND:

Selected 5-year survival results after liver transplantation for hepatocellular carcinoma (HCC) have been reported to be 70%. Our hypothesis was that liver transplantation is effective for long-term cancer control for HCC.
STUDY DESIGN:

A 20-year retrospective review of a prospectively collected database was carried out. Demographic data and patient survival were calculated.
RESULTS:

There were 1,422 liver transplantations performed between January 1990 and April 2011. Of these, 264 had HCC and 157 (59%) were pretreated with transarterial chemoembolization. Recipient age was 55.9 (± 7.9) years and 208 (79%) of patients were male. The underlying disease was hepatitis C virus in 155 (58.7%), hepatitis B virus in 16 (6%), alcohol in 21 (8%), and miscellaneous in the remaining 72 cases. The mean number of tumors was 1.8 (± 1.7) and the mean largest tumor diameter was 2.3 (± 1.3) cm in the explanted liver. One, 5, and 10-year patient survival was 88.5%, 69.1%, and 40.5%, respectively; disease-specific survival was 99.1%, 94.4% and 87.9%; and disease-free survival was 86.0%, 64.6%, and 40.1%. One, 5, and 10-year graft survival was 87.3%, 68.0%, and 41.8%. Nine (3.4%) patients required retransplantation; 75 patients (28.4%) have died, but only 10 of 75 (13.3%) died of recurrent HCC (3.7% of all HCC patients receiving a transplant) and 6 (8%) died of recurrent viral hepatitis. An additional 9 recipients developed recurrence (total HCC recurrence, n = 19 [7%]), 4 of whom died of causes other than HCC. The remaining 5 are disease-free post-treatment (mean 5.5 years after orthotopic liver transplantation).
CONCLUSIONS:

Orthotopic liver transplantation offers an effective treatment strategy for HCC in the setting of cirrhosis, even in the setting of hepatitis C virus. Hepatocellular carcinoma recurrence is uncommon in properly selected patients and disease-specific long-term survival approaches 90%.

肝胆速递

研究科尔外科。 2012 07 215（1）:19-28;讨论28-30。 EPUB 2012年5月18日。
肝癌肝移植长期的结果表明，疗效良好。
多伊尔N，MB，Vachharajani：Wellen JR，安德森谢诺伊小号，梅纳德E，C，洛厄尔JA，查普曼厕所。
源

外科部，腹腔移植组，华盛顿大学医学院，圣路易斯，MO 63110，USA。
抽象
背景：

选择为肝细胞肝癌（HCC）肝移植术后5年生存率结果被报道为70％。我们的假设是长期控制癌症为肝癌肝移植是有效的。
研究设计：

20年的回顾性分析前瞻性收集的数据库进行了研究。人口数据和患者的生存率进行了计算。
结果：

1990年1月至2011年4月进行的1422例肝移植。其中，264例肝癌和157例（59％），肝动脉栓塞化疗预处理。受者年龄为55.9（±7.9）岁和208（79％）患者为男性。潜在的疾病是C型肝炎病毒，155人（58.7％），B型肝炎病毒16（6％），酒精含量21（8％），和杂项在其余72宗个案。肿瘤的平均数目为1.8（±1.7）的平均肿瘤最大直径为2.3（±1.3）厘米取出的肝脏。一，5，和10年生存率分别为88.5％，69.1％和40.5％，分别疾病特异生存率为99.1％，94.4％和87.9％，无病生存率分别为86.0％，64.6％，和40.1％。一，5，和10年移植肾存活率分别为87.3％，68.0％和41.8％。 9个（3.4％）患者需要再移植75例（28.4％）已经死了，但只有10死亡75例（13.3％）死于复发性肝癌所有接受移植的肝癌患者（3.7％）和6（8％）经常病毒性肝炎。另外9收件人复发（总肝癌复发，N = 19 [％]），其中4人死于肝癌以外的原因。其余5个是无病的治疗后（平均5.5年后原位肝移植）。
结论：

原位肝移植提供了一种有效的治疗策略为HC​​C在肝硬化的设置，即使在C型肝炎病毒的设置。肝癌复发是罕见的，在选择合适的患者和特定疾病的长期生存率接近90％。

咬牙硬挺

不得已而采取的手段，希望干细胞生成器官技术能尽快造福人类