Resection or transplant-listing for solitary hepatitis C-associated hepatocellular carcinoma: an intention-to-treat analysis.

Published

Journal Article

OBJECTIVES: The relative roles of liver resection (LR) and liver transplantation (LT) in the treatment of a solitary hepatocellular carcinoma (HCC) remain unclear. This study was conducted to provide a retrospective intention-to-treat comparison of these two curative therapies. METHODS: Records maintained at the study centre for all patients treated with LR or listed for LT for hepatitis C-associated HCC between January 2002 and December 2007 were reviewed. Inclusion criteria required: (i) an initial diagnosis of a solitary HCC lesion measuring ≤ 5 cm, and (ii) Child-Pugh class A or B cirrhosis. The primary endpoint analysed was intention-to-treat survival. RESULTS: A total of 75 patients were listed for transplant (LT-listed group) and 56 were resected (LR group). Of the 75 LT-listed patients, 23 (30.7%) were never transplanted because they were either removed from the waiting list (n = 13) or died (n = 10). Intention-to-treat median survival was superior in the LR group compared with the LT-listed group (61.8 months vs. 30.6 months), but the difference did not reach significance. Five-year recurrence was higher in the LR group than in the 52 LT patients (71.5% vs. 30.5%; P < 0.001). CONCLUSIONS: In the context of limited donor organ availability, partial hepatectomy represents an efficacious primary approach in properly selected patients with hepatitis C-associated HCC.

Full Text

Duke Authors

Cited Authors

  • Sogawa, H; Shrager, B; Jibara, G; Tabrizian, P; Roayaie, S; Schwartz, M

Published Date

  • February 2013

Published In

Volume / Issue

  • 15 / 2

Start / End Page

  • 134 - 141

PubMed ID

  • 23036070

Pubmed Central ID

  • 23036070

Electronic International Standard Serial Number (EISSN)

  • 1477-2574

International Standard Serial Number (ISSN)

  • 1365-182X

Digital Object Identifier (DOI)

  • 10.1111/j.1477-2574.2012.00548.x

Language

  • eng