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【medical-news】肝癌肝移植:超过米兰标准患者先肝
Author:M. Ravaioli a , G. L. Grazi a,*, F. Piscaglia b , F. Trevisani b , M. Cescon a , G. Ercolani a , M. Vivarelli a , R. Golfieri c , A. D'Errico Grigioni d , I. Panzini e , C. Morelli a , M. Bernardi b , L. Bolondi b and A. D. Pinna a
source:American Journal of Transplantation 25 Sep 2008
IF:6.423(2007)
Conventional criteria for liver transplantation for patients with hepatocellular carcinoma are single HCC ≤ 5 cm or less than or equal to three HCCs ≤ 3 cm. We prospectively evaluated the possibility of slightly extending these criteria in a down-staging protocol, which included patients initially outside conventional criteria: single HCC 5–6 cm or two HCCs ≤ 5 cm or less than six HCCs ≤ 4 cm and sum diameter ≤ 12 cm, but within Milan criteria in the active tumors after the down-staging procedures. The outcome of patients down-staged was compared to that of Milan criteria after liver transplantation and since the first evaluation according to an intention-to-treat principle. From 2003 to 2006, 177 patients with HCC were considered for transplantation: the transplantation rate was comparable between the Milan and down-staging groups: 88/129 cases (68%) versus 32/48 cases (67%), respectively. At a median follow-up of 2.5 years after transplantation, the 1 and 3 years' disease-free survival rates were comparable: 80% and 71% in the Milan group versus 78% and 71% in the down-staging. The actuarial intention-to-treat survival was 27/48 patients (56.3%) in the down-staging and 81/129 cases (62.8%) in the Milan group, p = n.s. The proposed down-staging criteria provide a comparable outcome to the conventional criteria. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 肝癌肝移植：起始超过米兰标准的患者降期治疗后的结果
肝细胞肝癌患者传统的肝移植标准（米兰标准）是：单个肿瘤≤ 5 cm或肿瘤不超过3个、每个肿瘤≤ 3 cm。我们对降期处理是否可以稍微扩大肝癌肝移植标准的可能性进行了前瞻性研究，选取发病起始超越米兰标准的病例：单个肿瘤5–6 cm或2个肿瘤≤ 5 cm或肿瘤少于6个、每个肿瘤≤ 4 cm且总直径≤ 12 cm，行降期治疗措施后肿瘤符合米兰标准。比较降期治疗的患者与符合米兰标准的患者的肝移植术后预后和根据意向处理原则的首次评估结果。从2003年到2006年，共有177例肝癌患者曾被考虑行肝移植术，米兰组和降期治疗组的移植率分别为88/129例 (68%) 、 32/48 例 (67%)。移植术后中位随访时间2.5年，1年、3年无病生存率分别为：米兰组为80% 、71%，降期治疗组为78% 、71%。降期治疗组的意向处理生存率为27/48例 (56.3%)，米兰组为81/129例(62.8%)，p = n.s.（由此可见）符合降期治疗标准的患者肝移植术后的效果和米兰标准相当。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-03-25 15:19
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