Journal article
Liver Transplant vs Liver Resection in patients with Multifocal hepatocellular Carcinoma
Journal of gastrointestinal surgery, Vol.28(7), pp.1062-1066
07/2024
DOI: 10.1016/j.gassur.2024.04.021
PMID: 38653337
Abstract
The optimal surgical option in patients with Multifocal hepatocellular Carcinoma (MHCC) is an area of active research. The preference varies based on geographic variations and institutional policies. We sought to determine long-term outcomes in patients with MHCC based on surgical treatment - Liver transplant (LT) vs resection (LR).
We performed a retrospective analysis of NCDB (2004-2015) and identified patients with MHCC within Milan criteria. Patients with αfetoprotein ≥1000 nanograms/milliliter and those who underwent ablation were excluded. The primary outcome measure was long-term survival in patients undergoing LT vs. LR. The secondary aim of our study was to determine clinicodemographic factors associated with the receipt of LT and LR.
1,546 patients were included, of whom 1,211 received LT and 335 underwent LR. Patients who were non-Hispanic White (70.8% vs.54.9% p <0.01), privately insured (53.7% vs. 36.7%, p <0.01), and treated at academic centers (85.4% vs. 71.6%, p<0.01) were more likely to receive an LT. Multivariable Cox analysis revealed LT was associated with improved survival compared to LR ( HR= 0.34, 95% CI= 0.28-0.42).
We described clinical and sociodemographic differences in LT and LR patients and found LT to be associated with a decreased mortality risk compared to LR. The study's findings should be interpreted in the context of several limitations, including the selection of MHCC criteria within Milan criteria.
Details
- Title: Subtitle
- Liver Transplant vs Liver Resection in patients with Multifocal hepatocellular Carcinoma
- Creators
- Hanna Kakish - University Hospitals of ClevelandMohammed O Suraju - University of IowaAbhinav Seth - University of IowaOlivia N DiGioia - University of IowaOmkar Pawar - University Hospitals of ClevelandYong K Kwon - University of WashingtonAlan W Hemming - University of IowaHassan Aziz - Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA. Electronic address: Hassan-aziz@uiowa.edu
- Resource Type
- Journal article
- Publication Details
- Journal of gastrointestinal surgery, Vol.28(7), pp.1062-1066
- DOI
- 10.1016/j.gassur.2024.04.021
- PMID
- 38653337
- NLM abbreviation
- J Gastrointest Surg
- eISSN
- 1873-4626
- Language
- English
- Electronic publication date
- 04/21/2024
- Date published
- 07/2024
- Academic Unit
- Surgery; Otolaryngology
- Record Identifier
- 9984618503102771
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