Liver Transplantation for Hepatocellular Carcinoma: Malatya Experience and Proposals for Expanded Criteria
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Erişim
info:eu-repo/semantics/closedAccessTarih
2020Yazar
Volkan İnceSami Akbulut
Emrah Otan
Veysel Ersan
Serdar Karakaş
Tolga Tevfik Şahin
Brian I Carr
Adil Baskiran
Emine Şamdancı
Harika Gözükara Bağ
Cemalettin Koç
Sertaç Usta
Fatih Özdemir
Bora Barut
Fatih Gönültas
Barış Sarıcı
Koray Kutluturk
Murat Sait Dogan
Dinçer Özgör
Mustafa Dikilitaş
Murat Harputluoglu
Murat Aladağ
Ramazan Kutlu
Ilknur Varol
Abuzer Dirican
Cemalettin Aydın
Burak Işık
Cengiz Ara
Cüneyt Kayaalp
Şükrü Emre
Sezai Yılmaz
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Ince, V., Akbulut, S., Otan, E., Ersan, V., Karakas, S., Sahin, T. T., ... & Yilmaz, S. (2020). Liver transplantation for hepatocellular carcinoma: Malatya experience and proposals for expanded criteria. Journal of Gastrointestinal Cancer, 51(3), 998-1005.Özet
Survival was examined from a Turkish liver transplant center of patients with HCC, to identify prognostic factors. Data from 215
patients who underwent predominantly live donor liver transplant for HCC at our institute over 12 years were included in the
study and prospectively recorded. They were 152 patients within and 63 patients beyond Milan criteria. Patients beyond Milan
criteria were divided into two groups according to presence or absence of tumor recurrence. Recurrence-associated factors were
analyzed. These factors were then applied to the total cohort for survival analysis. We identified four factors, using multivariate
analysis, that were significantly associated with tumor recurrence. These were maximum tumor diameter, degree of tumor
differentiation, and serum AFP and GGT levels. A model that included all four of these factors was constructed, the ‘Malatya
criteria.’ Using these Malatya criteria, we estimated DFS and cumulative survival, for patients within and beyond these criteria,
and found statistically significant differences with improved survival in patients within Malatya criteria of 1, 5, and 10-year
overall survival rates of 90.1%, 79.7%, and 72.8% respectively, which compared favorably with other extra-Milan extended
criteria. Survival of our patients within the newly defined Malatya criteria compared favorably with other extra-Milan extended
criteria and highlight the usefulness of serum AFP and GGT levels in decision-making.