Survival analysis of patients with stage I and II hepatocellular carcinoma after a liver transplantation or liver resection. Issue 12 (25th June 2014)

• Record Type: Journal Article
• Authors: Seshadri, Ramanathan M.; Besur, Siddesh; Niemeyer, David J.; Templin, Megan; McKillop, Iain H.; Swan, Ryan Z.; Martinie, John B.; Russo, Mark W.; Iannitti, David A.
• Is Part Of: HPB. Volume 16:Issue 12(2014:Dec.)
• Page Start: 1102
• Page End: 1109
• Publication Date: 2014-06-25
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/hpb.12300
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Introduction: Liver transplantation (LT) is a treatment option in select patients with hepatocellular carcinoma (HCC). The aim of the present study was to compare survival in Stage I or II HCC patients undergoing either liver transplant (LT) or a liver resection (LR). Method: The study is a retrospective analysis of the National Cancer Data Base (1998–2011). In total, 148 882 patients with liver cancer were identified, of which 5‐year survival data (1998–2006) were available for 64 227 patients. Patients were stratified by the American Joint Committee on Cancer (AJCC) clinical stage I and II. Kaplan–Meier curves and log‐rank tests were used for statistical analysis. Results: 3340 HCC patients met analysis criteria. Among stage I HCC, 860 had LT and 871 had LR. Among stage II HCC, 833 had LT and 776 LR. In stage I patients the median survival for LT and LR were 127.9 and 56.7 months, respectively, ( P < 0.0001) and in stage II patients the median survival was 110.8 and 42.8 months ( P < 0.0001). Unlike LT patients, LR patients with Stage I HCC had a longer median survival compared with Stage II patients ( P = 0.0002). Conclusion: Liver transplantation offers a survival advantage compared with a liver resection among patients with Stage I and II HCC. LT is the best surgical treatment for early stage (I/II) HCC in patients with advanced fibrosis or cirrhosis, whereas LR provides equivalent outcomes to LT in patients without advanced fibrosis and should be considered as the first surgical option.