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Трансплантация печени при гепатоцеллюлярной карциноме
Хубутия М.Ш., Новрузбеков М.С., Олисов О.Д. и др. Трансплантация печени при гепатоцеллюлярной карциноме.Современная онкология. 2015; 17 (2): 8–13.
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Khubutiya M.Sh., Novruzbekov M.S., Olisov O.D. et al. Liver transplantation for hepatocellular carcinoma. Journal of modern oncology. 2015; 17 (2): 8–13.
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Аннотация
Гепатоцеллюлярный рак (ГЦР) является одним из наиболее распространенных видов опухоли, развивающийся, как правило, на фоне цирроза. Ортотопическая трансплантация печени (ОТП) – один из вариантов лечения ГЦР. Пятьдесят пациентов с ГЦР, перенесших ОТП, были рандомизированы в 2 группы в соответствии с Миланскими критериями. Произведена оценка различий в до- и послеоперационном стадировании опухолевого процесса. Показатели 1-, 3- и 5-летней безрецидивной выживаемости в группе Миланских критериев были достоверно выше, чем у пациентов в контрольной группе: 100, 100, 87,5% и 58, 41, 27% соответственно. Показатели общей 1-, 3- и 5-летней выживаемости в группе Миланских критериев составили 100, 100, 87,5% и 76,9, 45, 29,5% у пациентов, выходящих за пределы Миланских критериев.
Вывод: наилучшие отдаленные результаты ОТП при ГЦР достигаются у пациентов в группе Миланских критериев.
Ключевые слова: трансплантация печени, гепатоцеллюлярный рак, Миланские критерии, сорафениб.
Вывод: наилучшие отдаленные результаты ОТП при ГЦР достигаются у пациентов в группе Миланских критериев.
Ключевые слова: трансплантация печени, гепатоцеллюлярный рак, Миланские критерии, сорафениб.
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Hepatocellular carcinoma (HCC) is one of the most frequent cancer, usually develops in cirrhotic liver. Liver transplantation (LT) is potentially curative treatment for HCC. A total of 50 patients with HCC underwent LT. Patients were divided and compared according to Milan criteria. Differences between pre- and post-operative assessment were evaluated. Overall survival (OS) and disease-free survival (DFS) were compared between groups. Patients within MC had a significant better 1-, 3- and 5-year survival than a control group: 100, 100, 87,5% vs. 58, 41 и 27% for DFS and 100, 100, 87,5% vs. 76,9, 45 и 29,5% for OS.
Conclusion: long-term results in patients with HCC after LT is excellent if tumor characteristics are within the Milan criteria.
Key words: liver transplantation, hepatocellular carcinoma, the Milan criteria, sorafenib.
Полный текст
Список литературы
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14. Sirivatanauksorn Y, Tovikkai C. Comparison of staging systems of hepatocellular carcinoma. HPB Surgery Volume 2011. ID 818217.
15. Mazzaferro V et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol 2009; 10: 35–43.
16. Mazzaferro V, Bhoori S, Sposito C et al. Milan criteria in liver transplantation for hepatocellular carcinoma: an evidence-based analysis of 15 years of experience. Liver Transplantation 2011; 17: s44–57.
17. Clavien PA et al. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. Lancet Oncol 2012; 13(1): e11–22.
18. Lei J, Wang W, Yan L. Up-to-seven criteria for hepatocellular carcinoma liver transplantation: a single center analysis. World J Gastroenterol 2013; 19 (36): 6077–83.
19. Bruix J, Raoul J-L, Sherman M, Mazzaferro V. Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma: subanalyses of a phase III trial. J Hepatology 2012; 57: 821–9.
20. Teng C, Hwang W, Chen Y et al. Sorafenib for hepatocellular carcinoma patients beyond Milan criteria after orthotopic liver transplantation: a case control study. World J Surg Oncology 2012; 10: 41.
21. Saab S, McTigue M, Finn RS, Busuttil RW. Sorafenib as adjuvant therapy for high-risk hepatocellular carcinoma in liver transplant recipients: feasibility and efficacy. Exp Clin Transplant 2010; 8 (4): 307–13.
22. Waghray A, Balci B, El-Gazzaz G et al. Safety and efficacy of sorafenib for the treatment of recurrent hepatocellular carcinoma after liver transplantation. Clin Transplant 2013; 27: 555–61; http://10.1111/ctr.12150
2. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update (AASLD Practice Guideline). Hepatology 2010.
3. Byam J, Renz J, Millis M. Liver transplantation for hepatocellular carcinoma. Hepatobiliary Surg Nutr 2013; 2 (1): 22–30.
4. Mazzaferro V, Regalia E, Doci R et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996; 334: 693–9.
5. Yao FY. Liver transplantation for hepatocellular carcinoma: beyond the Milan criteria. Am J Transplant 2008; 8 (10): 1982–9.
6. Yao FY, Ferrell L, Bass NM et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology 2001; 33: 1394–403.
7. Duffy JP, Vardanian A, Benjamin E et al. Liver transplantation criteria for hepatocellular carcinoma should be expanded: a 22-year experience with 467 patients at UCLA. Ann Surg 2007; 246: 502–11.
8. Xu X, Lu D, Ling Q et al. Liver transplantation for hepatocellular carcinoma beyond the Milan criteria. Gut 2015.
9. Mazzaferro V, Chun Y, Poon R et al. Liver transplantation for hepatocellular carcinoma. Ann Surg Oncology 2003; 15 (4): 1001–7.
10. Weledji E, Orock G, Ngowe M, Nsagha DS. How grim is hepatocellular carcinoma? Ann Med Surgery 2014; 3: 71–6.
11. Hackl C, Schlitt H, Kirchner G et al. Liver transplantation for malignancy: current treatment strategies and future perspectives. World J Gastroenterol 2014; 20 (18): 5331–44.
12. Asham EH, Mansour H, Ghobrial M. Liver transplantation for hepatocellular carcinoma. Cancer J 2014; 12; http://dx.doi.org/10.5772/55374
13. Sapisochin G, Fernandez de Sevilla E, Echeverri J, Charco R. Management of «very early» hepatocellular carcinoma on cirrhotic patients. World J Hepatol 2014; 6 (11): 766–75.
14. Sirivatanauksorn Y, Tovikkai C. Comparison of staging systems of hepatocellular carcinoma. HPB Surgery Volume 2011. ID 818217.
15. Mazzaferro V et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol 2009; 10: 35–43.
16. Mazzaferro V, Bhoori S, Sposito C et al. Milan criteria in liver transplantation for hepatocellular carcinoma: an evidence-based analysis of 15 years of experience. Liver Transplantation 2011; 17: s44–57.
17. Clavien PA et al. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. Lancet Oncol 2012; 13(1): e11–22.
18. Lei J, Wang W, Yan L. Up-to-seven criteria for hepatocellular carcinoma liver transplantation: a single center analysis. World J Gastroenterol 2013; 19 (36): 6077–83.
19. Bruix J, Raoul J-L, Sherman M, Mazzaferro V. Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma: subanalyses of a phase III trial. J Hepatology 2012; 57: 821–9.
20. Teng C, Hwang W, Chen Y et al. Sorafenib for hepatocellular carcinoma patients beyond Milan criteria after orthotopic liver transplantation: a case control study. World J Surg Oncology 2012; 10: 41.
21. Saab S, McTigue M, Finn RS, Busuttil RW. Sorafenib as adjuvant therapy for high-risk hepatocellular carcinoma in liver transplant recipients: feasibility and efficacy. Exp Clin Transplant 2010; 8 (4): 307–13.
22. Waghray A, Balci B, El-Gazzaz G et al. Safety and efficacy of sorafenib for the treatment of recurrent hepatocellular carcinoma after liver transplantation. Clin Transplant 2013; 27: 555–61; http://10.1111/ctr.12150
________________________________________________
1. Khan AS, Fowler KJ, Chapman WC. Current surgical treatment strategies for hepatocellular carcinoma in North America. World J Gastroenterol 2014; 20 (41): 15 007–17.
2. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update (AASLD Practice Guideline). Hepatology 2010.
3. Byam J, Renz J, Millis M. Liver transplantation for hepatocellular carcinoma. Hepatobiliary Surg Nutr 2013; 2 (1): 22–30.
4. Mazzaferro V, Regalia E, Doci R et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996; 334: 693–9.
5. Yao FY. Liver transplantation for hepatocellular carcinoma: beyond the Milan criteria. Am J Transplant 2008; 8 (10): 1982–9.
6. Yao FY, Ferrell L, Bass NM et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology 2001; 33: 1394–403.
7. Duffy JP, Vardanian A, Benjamin E et al. Liver transplantation criteria for hepatocellular carcinoma should be expanded: a 22-year experience with 467 patients at UCLA. Ann Surg 2007; 246: 502–11.
8. Xu X, Lu D, Ling Q et al. Liver transplantation for hepatocellular carcinoma beyond the Milan criteria. Gut 2015.
9. Mazzaferro V, Chun Y, Poon R et al. Liver transplantation for hepatocellular carcinoma. Ann Surg Oncology 2003; 15 (4): 1001–7.
10. Weledji E, Orock G, Ngowe M, Nsagha DS. How grim is hepatocellular carcinoma? Ann Med Surgery 2014; 3: 71–6.
11. Hackl C, Schlitt H, Kirchner G et al. Liver transplantation for malignancy: current treatment strategies and future perspectives. World J Gastroenterol 2014; 20 (18): 5331–44.
12. Asham EH, Mansour H, Ghobrial M. Liver transplantation for hepatocellular carcinoma. Cancer J 2014; 12; http://dx.doi.org/10.5772/55374
13. Sapisochin G, Fernandez de Sevilla E, Echeverri J, Charco R. Management of «very early» hepatocellular carcinoma on cirrhotic patients. World J Hepatol 2014; 6 (11): 766–75.
14. Sirivatanauksorn Y, Tovikkai C. Comparison of staging systems of hepatocellular carcinoma. HPB Surgery Volume 2011. ID 818217.
15. Mazzaferro V et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol 2009; 10: 35–43.
16. Mazzaferro V, Bhoori S, Sposito C et al. Milan criteria in liver transplantation for hepatocellular carcinoma: an evidence-based analysis of 15 years of experience. Liver Transplantation 2011; 17: s44–57.
17. Clavien PA et al. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. Lancet Oncol 2012; 13(1): e11–22.
18. Lei J, Wang W, Yan L. Up-to-seven criteria for hepatocellular carcinoma liver transplantation: a single center analysis. World J Gastroenterol 2013; 19 (36): 6077–83.
19. Bruix J, Raoul J-L, Sherman M, Mazzaferro V. Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma: subanalyses of a phase III trial. J Hepatology 2012; 57: 821–9.
20. Teng C, Hwang W, Chen Y et al. Sorafenib for hepatocellular carcinoma patients beyond Milan criteria after orthotopic liver transplantation: a case control study. World J Surg Oncology 2012; 10: 41.
21. Saab S, McTigue M, Finn RS, Busuttil RW. Sorafenib as adjuvant therapy for high-risk hepatocellular carcinoma in liver transplant recipients: feasibility and efficacy. Exp Clin Transplant 2010; 8 (4): 307–13.
22. Waghray A, Balci B, El-Gazzaz G et al. Safety and efficacy of sorafenib for the treatment of recurrent hepatocellular carcinoma after liver transplantation. Clin Transplant 2013; 27: 555–61; http://10.1111/ctr.12150
Авторы
М.Ш.Хубутия, М.С.Новрузбеков, О.Д.Олисов*, И.Е.Галанкина, Л.Н.Зимина
ГБУЗ НИИ скорой помощи им. Н.В.Склифосовского Департамента здравоохранения г. Москвы. 129010, Россия, Москва, Большая Сухаревская площадь, д. 3
*dr.olisov@gmail.com
ГБУЗ НИИ скорой помощи им. Н.В.Склифосовского Департамента здравоохранения г. Москвы. 129010, Россия, Москва, Большая Сухаревская площадь, д. 3
*dr.olisov@gmail.com
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M.Sh.Khubutiya, M.S.Novruzbekov, O.D.Olisov*, I.E.Galankina, L.N.Zimina
SFHI N.V.Sklifosovsky Research Institute for Emergency Care Moscow City Health Department. 129010, Russian Federation, Moscow, Bol'shaia Sukharevskaia ploshchad', d. 3.
*dr.olisov@gmail.com
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