Journal article
Outcomes of Liver Transplantation in 490 Patients with Hepatocellular Carcinoma: Validation of a Uniform Staging after Surgical Treatment
Journal of the American College of Surgeons, Vol.204(5), pp.1016-1027
2007
DOI: 10.1016/j.jamcollsurg.2006.12.043
PMID: 17481532
Abstract
The aim of this study was to compare the ability of staging systems (American Joint Committee on Cancer/Union Internationale contre le Cancer [AJCC/UICC], Japanese TNM, Pittsburgh, United Network for Organ Sharing [UNOS], Cancer of the Liver Italian Program [CLIP], Japan Integrated Staging [JIS], and Barcelona Clinic Liver Cancer [BCLC]) to predict survival after liver transplantation for hepatocellular carcinoma.
Four hundred ninety consecutive patients who underwent liver transplantation for hepatocellular carcinoma at 4 centers (1985 to 2005) were identified using a registry (US, Belgium, Germany). End points were overall (OS) and recurrence-free survival (RFS). Survival by stage was compared with the log-rank test. Sequential stage-wise discrimination of each system was evaluated using Cox regression.
Three- and 5-year overall survival rates were 71% and 64%, respectively; recurrence-free survival rates were 67% and 61%, respectively. Median followup among 327 living and 308 recurrence-free patients was 40 months. In only three systems—AJCC/UICC, Japanese TNM, and Pittsburgh—were overall and recurrence-free survivals longer for patients with low stage versus more advanced stage. For overall and recurrence-free survivals, sequential stages were different only for AJCC/UICC. In the Japanese TNM system, stages II and I were similar; for Pittsburgh, grades 3 and 2 were similar. For the United Network for Organ Sharing system, stages II and I and stages IVA1 and III were similar. All stages were similar for the Cancer of the Liver Italian Program. For the Japan Integrated Staging, scores 2 and 1 and scores 4 and 3 were similar. In the Barcelona Clinic Liver Cancer, stage D patients had significantly better survival than patients at stage C.
The AJCC/UICC staging system provides the best stratification of prognosis for patients undergoing liver transplantation for hepatocellular carcinoma. This confirms previous analyses in patients treated with hepatic resection. The AJCC/UICC staging system should be considered for uniform prediction of outcomes after surgery for hepatocellular carcinoma.
Details
- Title: Subtitle
- Outcomes of Liver Transplantation in 490 Patients with Hepatocellular Carcinoma: Validation of a Uniform Staging after Surgical Treatment
- Creators
- Jean-Nicolas Vauthey - The University of Texas MD Anderson Cancer CenterDario Ribero - The University of Texas MD Anderson Cancer CenterEddie K. Abdalla - The University of Texas MD Anderson Cancer CenterSven Jonas - Charité - Universitätsmedizin BerlinAnkit Bharat - Washington University in St. LouisGuido Schumacher - Charité - Universitätsmedizin BerlinJan Lerut - UCLouvainWilliam C. Chapman - Washington University in St. LouisAlan W. Hemming - University of Florida Health Science CenterPeter Neuhaus - Charité - Universitätsmedizin Berlin
- Resource Type
- Journal article
- Publication Details
- Journal of the American College of Surgeons, Vol.204(5), pp.1016-1027
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jamcollsurg.2006.12.043
- PMID
- 17481532
- ISSN
- 1072-7515
- eISSN
- 1879-1190
- Language
- English
- Date published
- 2007
- Academic Unit
- Surgery
- Record Identifier
- 9984322934102771
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