| 1 | Role of immunosuppression and tumor differentiation in predicting recurrence after liver transplantation for hepatocellular carcinoma: A multicenter study of 412 patients显示文摘AIM: To assess pre-orthotopic liver transplantation (OLT) factors that could be evaluated pre-operatively or con- trolled post-operatively associated with hepatocellular carcinoma (HCC) recurrence and disease-free survival after liver transplantation (LT).METHODS: Four hundred and twelve patients trans- planted for HCC between 1988 and 1998 in 14 French centers, who survived the postoperative period were studied. Kaplan Meier estimates were calculated for 24 variables potentially associated with recurrence of HCC. Uni- and multivariate analyses were conducted to iden- tify independent predictors of recurrence. RESULTS: Overall 5-year disease-free survival was 57.1%. By univariate analysis, variables associated with disease-free survival were: presence of cirrhosis (P = 0.001), etiology of liver disease (P = 0.03), α fetoprotein level (< 200, 200 to 2000, or > 2000; P < 0.0001), γ-GT activity (N, N to 2N or > 2N; P = 0.02), the number of nodules (1, 2-3 or ≥ 4; P = 0.02), maximal diameter of the largest nodule (< 3 cm, 3 to 5 cm or > 5 cm; P < 0.0001), the sum of the diameter of the nodules (< 3 cm, 3 to 5 cm, 5 to 10 cm or >10 cm; P < 0.0001), bi- lobar location (P = 0.01), preoperative portal thrombosis (P < 0.0001), peri-operative treatment of the tumor (P = 0.002) and chemoembolization (P = 0.03), tumor differentiation (P = 0.01), initial type of calcineurin inhibitor (P = 0.003), the use of antilymphocyte antibodies (P = 0.02), rejection episodes (P = 0.003) and period of LT (P < 0.0001). By multivariate analysis, 6 variables were independently associated with HCC recurrence: maximal diameter of the largest nodule (P < 0.0001), time of LT (P < 0.0001), tumor differentiation (P < 0.0001), use of anti-lymphocyte antibody (ATG) or anti-CD3 antibody (OKT3) (P = 0.005), preoperative portal thrombosis (P = 0.06) and the number of nodules (P = 0.06). CONCLUSION: This study identif ies immunosuppression, through the use of ATG or OKT3, as a predictive factor of tumor recurrence, and confi rms the prognostic value of tumor differentiation. | Thomas Decaens Franoise Roudot-Thoraval Solange Bresson-Hadni Carole Meyer Jean Gugenheim Francois Durand Pierre-Henri Bernard Olivier Boillot Philippe Compagnon Yvon Calmus Jean Hardwigsen Christian Ducerf Georges Philippe Pageaux Sébastien Dharancy Olivier Chazouillères Daniel Cherqui Christophe Duvoux | 2006 | World Journal of Gastroenterology2006，12，45： | 10 |
| 6 | Polymorphic multiple hepatocellular adenoma including a non-steatotic HNF1α-inactivated variant显示文摘To the Editor:Hepatocellular adenomas (HCAs) consist of benign liver tumors favored by the use of oral contraceptives, which preferentially occur in women.[1, 2] They expose to the risk of hemorrhage (20% of cases) and more rarely, to the risk of malignant transformation (4%-10% of cases).[3, 4] Multiple HCAs, which are defined by the presence of 10 or more HCAs, were first described in 1985 and were initially considered having a worse prognosis than single HCA.[5]However, recent reports have suggested that the risk of complications in patients with multiple HCAs was not related to the number of lesions, but mainly to three other factors: i) tumor size >5 cm for the risk of both hemorrhage and malignant transformation;[3] ii) male gender and iii) β-catenin-mutation for the risk of malignant transformation.[6] Progresses made in terms of genotypic knowledge of HCA have allowed to identify different subtypes of HCA associated with more specific risks of complication.[7] | Kayvan Mohkam Benjamin Darnis Jean-Baptiste Cazauran Agnès Rode Anne-Frédérique Manichon Christian Ducerf Brigitte Bancel Jean-Yves Mabrut | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，5： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员