Influence of prognostic factors on the outcome of liver transplantation for hepatocellular carcinoma on cirrhosis: A univariate and multivariate analysis

Massimo Del Gaudio, Gian Luca Grazi, Alfonso Principe, Matteo Ravaioli, Giorgio Ercolani, Matteo Cescon, Giovanni Varotti, Andrea Gardini, Antonino Cavallari

Research output: Contribution to journalArticle

Abstract

Background/Aims: Hepatocellular carcinoma is related to liver cirrhosis in 70-85% cases. During the '80s, the best treatment was represented by liver resection. Recently, liver transplantation has been introduced as an optimal therapeutic alternative. The purpose of this study is to select the best candidates for liver transplantation considering several prognostic factors that are related to tumor characteristics. Methodology: Among 573 liver transplantations, we have retrospectively analyzed 87 patients undergoing liver transplantation for hepatocellular carcinoma on cirrhosis; in 30 (34.5%) patients, hepatocellular carcinoma was an incidental finding in the surgical specimen. Results: Operative mortality was 2.2% (2/87). Twenty-five patients died during the follow-up. The main cause of death was represented by tumor recurrence in 10.3% of cases. The 3-year and 5-year overall survival was 71.6% and 66.2% respectively. On a univariate analysis, the only variable significantly related with overall-survival was alpha-fetoprotein levels (p=0.01). Furthermore, alpha-fetoprotein, the diameter of tumor greater than 3cm, the presence of satellite nodules, Edmonson's grade III-IV, micro-macro vascular thrombosis, and TNM stadium III-IV were significantly related with the development of tumor recurrence. On a multivariate analysis, only alpha-fetoprotein (p=0.01, Risk ratio = 2.7) resulted as a risk independent factor of patient overall-survival; vascular invasion (p=0.02, Risk ratio = 2.1) was predictive of tumor recurrence. Conclusions: Liver transplantation is a good therapeutic option in a selected group of patients, with a small nodule (

Original languageEnglish
Pages (from-to)510-514
Number of pages5
JournalHepato-Gastroenterology
Volume51
Issue number56
Publication statusPublished - Mar 2004

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Liver Transplantation
Hepatocellular Carcinoma
Fibrosis
Multivariate Analysis
alpha-Fetoproteins
Neoplasms
Recurrence
Blood Vessels
Survival
Odds Ratio
Incidental Findings
Liver Cirrhosis
Cause of Death
Thrombosis
Therapeutics
Mortality
Liver

Keywords

  • Cirrhosis
  • Hepatocellular carcinoma
  • Recurrence
  • Resection
  • Transplantation

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Influence of prognostic factors on the outcome of liver transplantation for hepatocellular carcinoma on cirrhosis : A univariate and multivariate analysis. / Del Gaudio, Massimo; Grazi, Gian Luca; Principe, Alfonso; Ravaioli, Matteo; Ercolani, Giorgio; Cescon, Matteo; Varotti, Giovanni; Gardini, Andrea; Cavallari, Antonino.

In: Hepato-Gastroenterology, Vol. 51, No. 56, 03.2004, p. 510-514.

Research output: Contribution to journalArticle

Del Gaudio, M, Grazi, GL, Principe, A, Ravaioli, M, Ercolani, G, Cescon, M, Varotti, G, Gardini, A & Cavallari, A 2004, 'Influence of prognostic factors on the outcome of liver transplantation for hepatocellular carcinoma on cirrhosis: A univariate and multivariate analysis', Hepato-Gastroenterology, vol. 51, no. 56, pp. 510-514.
Del Gaudio, Massimo ; Grazi, Gian Luca ; Principe, Alfonso ; Ravaioli, Matteo ; Ercolani, Giorgio ; Cescon, Matteo ; Varotti, Giovanni ; Gardini, Andrea ; Cavallari, Antonino. / Influence of prognostic factors on the outcome of liver transplantation for hepatocellular carcinoma on cirrhosis : A univariate and multivariate analysis. In: Hepato-Gastroenterology. 2004 ; Vol. 51, No. 56. pp. 510-514.
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abstract = "Background/Aims: Hepatocellular carcinoma is related to liver cirrhosis in 70-85{\%} cases. During the '80s, the best treatment was represented by liver resection. Recently, liver transplantation has been introduced as an optimal therapeutic alternative. The purpose of this study is to select the best candidates for liver transplantation considering several prognostic factors that are related to tumor characteristics. Methodology: Among 573 liver transplantations, we have retrospectively analyzed 87 patients undergoing liver transplantation for hepatocellular carcinoma on cirrhosis; in 30 (34.5{\%}) patients, hepatocellular carcinoma was an incidental finding in the surgical specimen. Results: Operative mortality was 2.2{\%} (2/87). Twenty-five patients died during the follow-up. The main cause of death was represented by tumor recurrence in 10.3{\%} of cases. The 3-year and 5-year overall survival was 71.6{\%} and 66.2{\%} respectively. On a univariate analysis, the only variable significantly related with overall-survival was alpha-fetoprotein levels (p=0.01). Furthermore, alpha-fetoprotein, the diameter of tumor greater than 3cm, the presence of satellite nodules, Edmonson's grade III-IV, micro-macro vascular thrombosis, and TNM stadium III-IV were significantly related with the development of tumor recurrence. On a multivariate analysis, only alpha-fetoprotein (p=0.01, Risk ratio = 2.7) resulted as a risk independent factor of patient overall-survival; vascular invasion (p=0.02, Risk ratio = 2.1) was predictive of tumor recurrence. Conclusions: Liver transplantation is a good therapeutic option in a selected group of patients, with a small nodule (",
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T1 - Influence of prognostic factors on the outcome of liver transplantation for hepatocellular carcinoma on cirrhosis

T2 - A univariate and multivariate analysis

AU - Del Gaudio, Massimo

AU - Grazi, Gian Luca

AU - Principe, Alfonso

AU - Ravaioli, Matteo

AU - Ercolani, Giorgio

AU - Cescon, Matteo

AU - Varotti, Giovanni

AU - Gardini, Andrea

AU - Cavallari, Antonino

PY - 2004/3

Y1 - 2004/3

N2 - Background/Aims: Hepatocellular carcinoma is related to liver cirrhosis in 70-85% cases. During the '80s, the best treatment was represented by liver resection. Recently, liver transplantation has been introduced as an optimal therapeutic alternative. The purpose of this study is to select the best candidates for liver transplantation considering several prognostic factors that are related to tumor characteristics. Methodology: Among 573 liver transplantations, we have retrospectively analyzed 87 patients undergoing liver transplantation for hepatocellular carcinoma on cirrhosis; in 30 (34.5%) patients, hepatocellular carcinoma was an incidental finding in the surgical specimen. Results: Operative mortality was 2.2% (2/87). Twenty-five patients died during the follow-up. The main cause of death was represented by tumor recurrence in 10.3% of cases. The 3-year and 5-year overall survival was 71.6% and 66.2% respectively. On a univariate analysis, the only variable significantly related with overall-survival was alpha-fetoprotein levels (p=0.01). Furthermore, alpha-fetoprotein, the diameter of tumor greater than 3cm, the presence of satellite nodules, Edmonson's grade III-IV, micro-macro vascular thrombosis, and TNM stadium III-IV were significantly related with the development of tumor recurrence. On a multivariate analysis, only alpha-fetoprotein (p=0.01, Risk ratio = 2.7) resulted as a risk independent factor of patient overall-survival; vascular invasion (p=0.02, Risk ratio = 2.1) was predictive of tumor recurrence. Conclusions: Liver transplantation is a good therapeutic option in a selected group of patients, with a small nodule (

AB - Background/Aims: Hepatocellular carcinoma is related to liver cirrhosis in 70-85% cases. During the '80s, the best treatment was represented by liver resection. Recently, liver transplantation has been introduced as an optimal therapeutic alternative. The purpose of this study is to select the best candidates for liver transplantation considering several prognostic factors that are related to tumor characteristics. Methodology: Among 573 liver transplantations, we have retrospectively analyzed 87 patients undergoing liver transplantation for hepatocellular carcinoma on cirrhosis; in 30 (34.5%) patients, hepatocellular carcinoma was an incidental finding in the surgical specimen. Results: Operative mortality was 2.2% (2/87). Twenty-five patients died during the follow-up. The main cause of death was represented by tumor recurrence in 10.3% of cases. The 3-year and 5-year overall survival was 71.6% and 66.2% respectively. On a univariate analysis, the only variable significantly related with overall-survival was alpha-fetoprotein levels (p=0.01). Furthermore, alpha-fetoprotein, the diameter of tumor greater than 3cm, the presence of satellite nodules, Edmonson's grade III-IV, micro-macro vascular thrombosis, and TNM stadium III-IV were significantly related with the development of tumor recurrence. On a multivariate analysis, only alpha-fetoprotein (p=0.01, Risk ratio = 2.7) resulted as a risk independent factor of patient overall-survival; vascular invasion (p=0.02, Risk ratio = 2.1) was predictive of tumor recurrence. Conclusions: Liver transplantation is a good therapeutic option in a selected group of patients, with a small nodule (

KW - Cirrhosis

KW - Hepatocellular carcinoma

KW - Recurrence

KW - Resection

KW - Transplantation

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