ALİ ÖZER
(Acibadem Mehmet Ali Aydinlar University Hospita)
Yıl: 2019Cilt: 26Sayı: 8ISSN: 2636-7688 / 2636-7688Sayfa Aralığı: 1704 - 1707İngilizce

71 0
Downstaging in patients with hepatocellular carcinoma: Is there real hope?
Aim: The conventional criteria preclude many patients with hepatocelular carcinom (HCC) from liver transplantation (LT). Recent studies reported comparable results in downstaged patients. In present study, the outcomes of patients with HCC after LT was evaluated in regard to response to a uniform downstaging protocol. Materials and Methods: The data of 136 HCC patients who underwent LT between January 2012 and April 2018 were analysed. 82 patients who were with minimum follow-up of one year and/or who reached the end-point (recurrence and/or death) were enrolled to the study and were divided into two groups as downstaging group and initially within Milan group. We retrospectively collected and then compared the baseline characteristics, postoperative complications, survival rate, and tumor recurrence rate of patients. Results: One of the study group included 54 (45.7%) patients within Milan criteria initially and there were 28 (23.7%) patients in the downstaging group. The disease-free survival rates were 82.1% and 87.1% in downstaging group and initially witihin Milan group, respectively (p=0.368). The overall 3-year survival rates were 82.1% and 88.9% in downstaging group and intially within Milan group, respectively (p=0.402). Conclusion: The patients who were initially excluded according to the current conventional criteria had a chance for LT with comparable outcome according to both the overall survival and disease-free survival rates.
Fen > Temel Bilimler > Biyoloji
Fen > Diş Hekimliği > Diş Hekimliği
Fen > Tıp > Alerji
Fen > Tıp > Anatomi ve Morfoloji
Fen > Tıp > Androloji
Fen > Tıp > Anestezi
Fen > Tıp > Odyoloji ve Konuşma-Dil Patolojisi
Fen > Tıp > Biyokimya ve Moleküler Biyoloji
Fen > Tıp > Biyofizik
Fen > Tıp > Biyoteknoloji ve Uygulamalı Mikrobiyoloji
Fen > Tıp > Kalp ve Kalp Damar Sistemi
Fen > Tıp > Hücre Biyolojisi
Fen > Tıp > Klinik Nöroloji
Fen > Tıp > Yoğun Bakım, Tıp
Fen > Tıp > Dermatoloji
Fen > Tıp > Acil Tıp
Fen > Tıp > Endokrinoloji ve Metabolizma
Fen > Tıp > Gastroenteroloji ve Hepatoloji
Fen > Tıp > Geriatri ve Gerontoloji
Fen > Tıp > Sağlık Bilimleri ve Hizmetleri
Fen > Tıp > Hematoloji
Fen > Tıp > İmmünoloji
Fen > Tıp > Enfeksiyon Hastalıkları
Fen > Tıp > Tamamlayıcı ve Entegre Tıp
Fen > Tıp > Tıbbi Etik
Fen > Tıp > Tıbbi İnformatik
Fen > Tıp > Tıbbi Laboratuar Teknolojisi
Fen > Tıp > Genel ve Dahili Tıp
Fen > Tıp > Adli Tıp
Fen > Tıp > Tıbbi Araştırmalar Deneysel
Fen > Tıp > Mikrobiyoloji
Fen > Tıp > Nörolojik Bilimler
Fen > Tıp > Kadın Hastalıkları ve Doğum
Fen > Tıp > Onkoloji
Fen > Tıp > Göz Hastalıkları
Fen > Tıp > Ortopedi
Fen > Tıp > Kulak, Burun, Boğaz
Fen > Tıp > Patoloji
Fen > Tıp > Pediatri
Fen > Tıp > Periferik Damar Hastalıkları
Fen > Tıp > Fizyoloji
Fen > Tıp > Temel Sağlık Hizmetleri
Fen > Tıp > Psikiyatri
Fen > Tıp > Halk ve Çevre Sağlığı
Fen > Tıp > Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme
Fen > Tıp > Rehabilitasyon
Fen > Tıp > Solunum Sistemi
Fen > Tıp > Romatoloji
Fen > Tıp > Spor Bilimleri
Fen > Tıp > Cerrahi
Fen > Tıp > Transplantasyon
Fen > Tıp > Tropik Tıp
Fen > Tıp > Üroloji ve Nefroloji
Fen > Eczacılık > Farmakoloji ve Eczacılık
Fen > Eczacılık > Toksikoloji
DergiAraştırma MakalesiErişime Açık
  • 1. Bryce K, Tsochatzis EA. Downstaging for hepatocellular cancer: harm or benefit?. Transl Gastroenterol Hepatol. 2017;2:106-19.
  • 2. Sharr WW, Chan SC, Lo CM. Section 3. Current status of downstaging of hepatocellular carcinoma before liver transplantation. Transplantation 2014;97:10-7.
  • 3. Toso C, Mentha G, Kneteman NM, et al. The place of downstaging for hepatocellular carcinoma. J Hepatol 2010;52:930-6.
  • 4. Yao FY, Mehta N, Flemming J, et al. Downstaging of hepatocellular cancer before liver transplant: long-term outcome compared to tumors within Milan criteria. Hepatology 2015;61:1968-77.
  • 5. Gordon-Weeks AN, Snaith A, Petrinic T, et al. Systematic review of outcome of downstaging hepatocellular cancer before liver transplantation in patients outside the Milan criteria. Br J Surg 2011;98:1201-8.
  • 6. Györi GP, Felsenreich DM, Silberhumer GR, et al. Multimodality locoregional treatment strategies for bridging HCC patients before liver transplantation. Eur Surg 2017;49:236-43.
  • 7. Lei J, Wang W, Yan L. Downstaging advanced hepatocellular carcinoma to the Milan criteria may provide a comparable outcome to conventional Milan criteria. J Gastrointest Surg 2013;17:1440-6.
  • 8. Pompili M, Francica G, Ponziani FR, et al. Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation. World J Gastroenterol 2013 21;19:7515-30.
  • 9. Pommergaard HC, Rostved AA, Adam R, et al. Locoregional treatments before liver transplantation for hepatocellular carcinoma: a study from the European Liver Transplant Registry. Transpl Int 2018;31:531-9.
  • 10. Lai Q, Avolio AW, Graziadei I, et al. α-fetoprotein and modified response evaluation criteria in Solid Tumors progression after locoregional therapy as predictors of hepatocellular cancer recurrence and death after transplantation. Liver Transpl 2013;19:1108-18.
  • 11. Chapman WC, Garcia-Aroz S, Vachharajani N, et al. Liver Transplantation for advanced hepatocellular carcinoma after downstaging without up-front stage restrictions. J Am Coll Surg 2017;224:610-21.
  • 12. Ravaioli M, Grazi GL, Piscaglia F, et al. Liver transplantation for hepatocellular carcinoma: results of down-staging in patients initially outside the Milan selection criteria. Am J Transplant 2008;8:2547-57.
  • 13. Kim Y, Stahl CC, Makramalla A, et al. Downstaging therapy followed by liver transplantation for hepatocellular carcinoma beyond Milan criteria. Surgery 2017;162:1250-8.
  • 14. Mehta N, Guy J, Frenette CT, et al. Excellent Outcomes of Liver Transplantation Following Down-Staging of Hepatocellular Carcinoma to Within Milan Criteria: A Multicenter Study. Clin Gastroenterol Hepatol 2018;16:955-64.
  • 15. Mehta N, Dodge JL, Roberts JP, Yao FY. Validation of the prognostic power of the RETREAT score for hepatocellular carcinoma recurrence using the UNOS database. Am J Transplant 2018;18:1206-13.
  • 16. Mazzaferro V, Sposito C, Zhou J, Pinna AD, De Carlis L, Fan J et al. Metroticket 2,0 Model for Analysis of Competing Risks of Death After Liver Transplantation for Hepatocellular Carcinoma. Gastroenterology 2018;154:128-39.

TÜBİTAK ULAKBİM Ulusal Akademik Ağ ve Bilgi Merkezi Cahit Arf Bilgi Merkezi © 2019 Tüm Hakları Saklıdır.