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首页> 外文期刊>Annals of Gastroenterological Surgery >Predictor of outcome after living donor liver transplantation for patients with hepatocellular carcinoma beyond the Japan criteria
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Predictor of outcome after living donor liver transplantation for patients with hepatocellular carcinoma beyond the Japan criteria

机译：在日本标准之外，肝细胞癌患者患有肝脏肝移植后的结果预测

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Background The Japan criteria (JC, maximum tumor size within 5?cm, within five tumor nodules, AFP within 500?ng/mL or within Milan criteria) have been applied to cadaveric liver transplantation (LT) for hepatocellular carcinoma (HCC) and will be used for living donor LT (LDLT) in Japan. The aim of this study was to verify the JC in LDLT and to clarify the risk factor of HCC recurrence and mortality after LDLT beyond the JC. Patients and methods Adult patients who underwent LDLT for end‐stage liver disease with HCC until October 2019 were reviewed retrospectively (n?=?246). Patients were divided into two groups according to whether they were within JC (n?=?203) or beyond JC (n?=?43). Recurrence‐free or overall survival rates after LDLT were compared. Univariate and multivariate analyses were performed to identify risk factors of HCC recurrence and HCC‐related mortality after LDLT for patients beyond the JC. Results Patients beyond the JC had significantly poorer 5‐year recurrence‐free (50.3% vs 95.9%, P ?.001) or overall (61.7% vs 98.1%, P ?.001) survival rates compared with patients within the JC. A multivariate analysis revealed that des‐gamma‐carboxy prothrombin (DCP)?≥?300?mAU/mL (hazard ratio 9.36, 95% CI; 2.41‐36.4, P =?.001) was an independent risk factor for HCC?recurrence and HCC‐related mortality (hazard ratio 13.8, 95% CI; 1.92‐98.6, P =?.01) after LDLT in patients beyond the JC. Conclusion The outcome of LDLT for patients within the JC was favorable. Patients beyond the JC with DCP?≥?300?mAU/mL might be contraindicated for LDLT.
机译：背景技术日本标准（JC，5℃内的最大肿瘤大小，在5例肿瘤结节内，500μg/ ml或米兰标准中的500？Ng / ml内）已经应用于肝细胞癌（HCC）的尸体肝移植（LT），并将用于日本的生活捐赠者LT（LDLT）。本研究的目的是验证LDLT中的JC，并在JC之外的LDLT之后阐明HCC复发和死亡率的风险因素。回顾性地审查了患者和方法，患者接受LDLT终末期肝病的患者，直到2019年10月到2019年10月（n？=？246）。根据它们是否在JC（n？=Δ203）或超出JC（n？= 43）中，患者分为两组。比较了LDLT后的复发或整体存活率。进行单变量和多变量分析以鉴定在JC之外的患者的LDLT后HCC复发和HCC相关死亡率的危险因素。结果超越JC的患者显着较差5年的复发（50.3％Vs 95.9％，P <α.001）或总体（61.7％与98.1％，P <001）生存率与JC内的患者相比。多变量分析显示DES-γ-羧基凝血酶原（DCP）？≥？300？MAU / mL（危险比9.36,95％CI; 2.41-36.4，P =？001）是HCC的独立危险因素？复发在JC之外的患者的LDLT后，与HCC相关的死亡率（危险比13.8,95％CI; 1.92-98.6，P = 01）。结论JC内患者LDLT的结果有利。患者超越JC的DCP？≥？300？MAU / ML可能对LDLT禁忌。

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