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Hepatic resection versus transplantation for hepatocellular carcinoma

Iwatsuki, S and Starzl, TE and Sheahan, DG and Yokoyama, I and Demetris, AJ and Todo, S and Tzakis, AG and Van Thiel, DH and Carr, B and Selby, R and Madariaga, J (1991) Hepatic resection versus transplantation for hepatocellular carcinoma. Annals of Surgery, 214 (3). 221 - 229. ISSN 0003-4932

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During the 10-year period (1980 to 1989), 76 patients with hepatocellular carcinoma (HCC) were treated by subtotal hepatic resection (HX) and 105 patients by orthotopic liver transplantation (TX) under cyclosporine-steroid therapy. Overall 1- to 5-year survival rates of the HX group were 71.1%, 55.0%, 47.2%, 37.2%, and 32.9%, respectively, and those of the TX group were 65.7%, 49.0%, 39.2%, 35.6%, and 35.6%, respectively. The survival rates after HX and after TX correlated well with pTNM stages and were similar in each stage between the two groups. However, when HCC was associated with cirrhosis of the liver, the survival rates after TX were significantly better than those after HX at each stage of pTNM classification. The tumor-recurrence rate was high both after HX (50%) and TX (43%), particularly in advanced stages of pTNM classification (60% or more). Twelve patients after HX and 13 patients after TX lived more than 5 years during this 10-year period. Fibrolamellar HCC and early stages of HCC were highly represented among the long-term survivors. Further improvement in survival rates depends on nonsurgical anti-cancer therapy before and/or after surgical removal of HCC.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Iwatsuki, S
Starzl, TEtes11@pitt.eduTES11
Sheahan, DG
Yokoyama, I
Demetris, AJ
Todo, S
Tzakis, AG
Van Thiel, DH
Carr, B
Selby, R
Madariaga, J
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1991
Date Type: Publication
Journal or Publication Title: Annals of Surgery
Volume: 214
Number: 3
Page Range: 221 - 229
DOI or Unique Handle: 10.1097/00000658-199109000-00005
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0003-4932
Other ID: uls-drl:31735062117761, Starzl CV No. 1225
Date Deposited: 08 Apr 2010 17:20
Last Modified: 09 Aug 2020 01:55


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