KOGISO Tomomi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Non peer reviewed
Title The Outcome of Salvage Liver Transplantation and Liver Resection for Recurrent Hepatocellular Carcinoma Using the 5-5-500 Rule, Japanese Extended Liver Transplantation Criteria for Hepatocellular Carcinoma
Journal Formal name:Transplantation proceedings
Abbreviation:Transplant Proc
ISSN code:18732623/00411345
Domestic / ForeginForegin
Volume, Issue, Page 55(4),pp.901-905
Author and coauthor HIRATA Yoshihiro, KOTERA Yoshihito, KATO Takaaki, ARIIZUMI Shunichi, KOGISO Tomomi, TOKUSHIGE Katsutoshi, HONDA Goro, EGAWA Hiroto
Publication date 2023/05
Summary BACKGROUND:Liver transplantation (LT) for hepatocellular carcinoma (HCC) is limited to Child-Pugh class C patients according to the Japanese HCC treatment algorithm. However, extended criteria of LT for HCC, known as the 5-5-500 rule, were published in 2019. Hepatocellular carcinoma reportedly has a high recurrence rate after primary treatment. We hypothesized that the outcome of recurrent HCC would be improved if the 5-5-500 rule were adopted for patients with recurrent HCC. We, therefore, analyzed the outcomes of surgical treatment (liver resection [LR] and LT) for recurrent HCC using the 5-5-500 rule in our institute.METHODS:Fifty-two patients younger than 70 years of age received surgical treatment for recurrent HCC using our institute's 5-5-500 rule from 2010 to 2019. We divided these patients into the LR and LT groups in the first study. The 10-year overall survival and re-recurrence-free survival were analyzed. The second study analyzed the risk factors of re-recurrence after surgical treatment for recurrent HCC.RESULTS:In the first study, the background characteristics of the 2 groups (LR and LT) showed no significant difference, except for age and Child-Pugh classification. There was no significant difference in the overall survival between groups (P = .35), but the re-recurrence-free survival in the LR group was significantly shorter than that in the LT group (P < .01). In the second study, the male sex and LR were risk factors of re-recurrence after surgical treatment for recurrent HCC. Child-Pugh's class did not contribute to re-recurrence.CONCLUSIONS:To improve the outcomes of recurrent HCC, LT is the better choice, regardless of the Child-Pugh class.
DOI 10.1016/j.transproceed.2023.04.028
PMID 37244836