Long term result of liver transplantation in patients with advanced hepatocellular carcinoma and the predictability of Pittsburg scoring system / 解放军医学杂志

ABSTRACT

Objective To investigate the long term result of orthotopic liver transplantation for advanced hepatocellular carcinoma, and to evaluate the predictability of Pittsburg scoring system. Methods 46 patients of advanced hepatocellular carcinoma received orthotopic liver transplantation in our center during October 2000 to December 2004. Data were collected and the 1-year and 3-year survival rates, were evaluated by Kaplan-Meier method. Based on the Pittsburg Scoring System, all cases were divided into 4 groups. The length of survival of each group was observed respectively, and differences were compared with Log-rank test. Results 3-year survival rate and tumor-free rate of all 46 patients were 46.7% and 38.8%, respectively. The mean tumor-free time was 27.7 months, and the mean survival time was 32.5 months. Among the 4 groups, no death or tumor relapse was detected in cases of grade 1 and grade 2 (group I) up to the present, whereas the 1-year tumor-free rate of grade 5(group IV) patients was only 12.5%, and no patient survived over 2 years. The 1-year and 3-year tumor-free rate among grade 3 and 4 (group II and III) patients were both about 65% and 40%, the mean tumor free time was about 32.5 and 24.3 months respectively, and there was no significant difference between 2 groups. In these two groups, the longest tumor free time was 58 months. Conclusions Some of the patients with advanced hepatocellular carcinoma still have the chance to survive tumor-free for a long time after liver transplantation. Pittsburg scoring system has more predictability than Milan criteria, especially in cases of grade 1, 2 and 5, but not so satisfactory in cases of grade 3 and 4.