Impact of tumor size, number of tumors and neutrophil-to-lymphocyte ratio in liver transplantation for recurrent hepatocellular carcinoma

Tomoharu Yoshizumi, Toru Ikegami, Shohei Yoshiya, Takashi Motomura, Yohei Mano, Jun Muto, Tetsuo Ikeda, Yuji Soejima, Ken Shirabe, Yoshihiko Maehara

Research output: Contribution to journalArticle

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Abstract

Aim: Hepatocellular carcinoma (HCC) is primarily treated with hepatic resection and/or locoregional therapy. When HCC recurs and further treatment is no longer possible owing to poor liver function, liver transplantation (LT) or living-donor LT (LDLT) is considered. The aim of this study was to clarify risk factors for tumor recurrence after LDLT in patients with recurrent HCC. Methods: The study comprised 104 patients who had undergone LDLT because of end-stage liver disease with recurrent HCC. The recurrence-free survival rates after the LDLT were calculated. Risk factors for tumor recurrence were identified. Results: The 1-, 3- and 5-year recurrence-free survival rates were 89.6%, 80.3% and 78.4%, respectively. By univariate analysis, the factors affecting recurrence-free survival were the sum of the largest tumor size and number of tumors of 8 or more (P<0.0001), des-γ-carboxy prothrombin of more than 300mAU/mL (P = 0.0001), and a neutrophil-to-lymphocyte ratio (NLR) of 4 or more (P = 0.0002), α-fetoprotein of more than 400ng/mL (P = 0.0001) and bilobar tumor distribution (P = 0.046). A multivariate analysis identified independent risk factors for post-LDLT tumor recurrence including the sum of tumor size and number of tumors of 8 or more (P = 0.0004) and an NLR of 4 or more (P = 0.01). The 1- and 3- year recurrence-free survival rates in the recipients who had both risk factors were 30.0% and 15.0%, respectively. Conclusion: LDLT should not be performed for patients who have both independent risk factors after any treatments for HCC.

Original languageEnglish
Pages (from-to)709-716
Number of pages8
JournalHepatology Research
Volume43
Issue number7
DOIs
Publication statusPublished - Jul 1 2013

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Living Donors
Liver Transplantation
Hepatocellular Carcinoma
Neutrophils
Lymphocytes
Recurrence
Neoplasms
Survival Rate
Fetal Proteins
End Stage Liver Disease
Liver
Prothrombin
Therapeutics
Multivariate Analysis
Survival

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Infectious Diseases

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Impact of tumor size, number of tumors and neutrophil-to-lymphocyte ratio in liver transplantation for recurrent hepatocellular carcinoma. / Yoshizumi, Tomoharu; Ikegami, Toru; Yoshiya, Shohei; Motomura, Takashi; Mano, Yohei; Muto, Jun; Ikeda, Tetsuo; Soejima, Yuji; Shirabe, Ken; Maehara, Yoshihiko.

In: Hepatology Research, Vol. 43, No. 7, 01.07.2013, p. 709-716.

Research output: Contribution to journalArticle

Yoshizumi, Tomoharu ; Ikegami, Toru ; Yoshiya, Shohei ; Motomura, Takashi ; Mano, Yohei ; Muto, Jun ; Ikeda, Tetsuo ; Soejima, Yuji ; Shirabe, Ken ; Maehara, Yoshihiko. / Impact of tumor size, number of tumors and neutrophil-to-lymphocyte ratio in liver transplantation for recurrent hepatocellular carcinoma. In: Hepatology Research. 2013 ; Vol. 43, No. 7. pp. 709-716.
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abstract = "Aim: Hepatocellular carcinoma (HCC) is primarily treated with hepatic resection and/or locoregional therapy. When HCC recurs and further treatment is no longer possible owing to poor liver function, liver transplantation (LT) or living-donor LT (LDLT) is considered. The aim of this study was to clarify risk factors for tumor recurrence after LDLT in patients with recurrent HCC. Methods: The study comprised 104 patients who had undergone LDLT because of end-stage liver disease with recurrent HCC. The recurrence-free survival rates after the LDLT were calculated. Risk factors for tumor recurrence were identified. Results: The 1-, 3- and 5-year recurrence-free survival rates were 89.6{\%}, 80.3{\%} and 78.4{\%}, respectively. By univariate analysis, the factors affecting recurrence-free survival were the sum of the largest tumor size and number of tumors of 8 or more (P<0.0001), des-γ-carboxy prothrombin of more than 300mAU/mL (P = 0.0001), and a neutrophil-to-lymphocyte ratio (NLR) of 4 or more (P = 0.0002), α-fetoprotein of more than 400ng/mL (P = 0.0001) and bilobar tumor distribution (P = 0.046). A multivariate analysis identified independent risk factors for post-LDLT tumor recurrence including the sum of tumor size and number of tumors of 8 or more (P = 0.0004) and an NLR of 4 or more (P = 0.01). The 1- and 3- year recurrence-free survival rates in the recipients who had both risk factors were 30.0{\%} and 15.0{\%}, respectively. Conclusion: LDLT should not be performed for patients who have both independent risk factors after any treatments for HCC.",
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TY - JOUR

T1 - Impact of tumor size, number of tumors and neutrophil-to-lymphocyte ratio in liver transplantation for recurrent hepatocellular carcinoma

AU - Yoshizumi, Tomoharu

AU - Ikegami, Toru

AU - Yoshiya, Shohei

AU - Motomura, Takashi

AU - Mano, Yohei

AU - Muto, Jun

AU - Ikeda, Tetsuo

AU - Soejima, Yuji

AU - Shirabe, Ken

AU - Maehara, Yoshihiko

PY - 2013/7/1

Y1 - 2013/7/1

N2 - Aim: Hepatocellular carcinoma (HCC) is primarily treated with hepatic resection and/or locoregional therapy. When HCC recurs and further treatment is no longer possible owing to poor liver function, liver transplantation (LT) or living-donor LT (LDLT) is considered. The aim of this study was to clarify risk factors for tumor recurrence after LDLT in patients with recurrent HCC. Methods: The study comprised 104 patients who had undergone LDLT because of end-stage liver disease with recurrent HCC. The recurrence-free survival rates after the LDLT were calculated. Risk factors for tumor recurrence were identified. Results: The 1-, 3- and 5-year recurrence-free survival rates were 89.6%, 80.3% and 78.4%, respectively. By univariate analysis, the factors affecting recurrence-free survival were the sum of the largest tumor size and number of tumors of 8 or more (P<0.0001), des-γ-carboxy prothrombin of more than 300mAU/mL (P = 0.0001), and a neutrophil-to-lymphocyte ratio (NLR) of 4 or more (P = 0.0002), α-fetoprotein of more than 400ng/mL (P = 0.0001) and bilobar tumor distribution (P = 0.046). A multivariate analysis identified independent risk factors for post-LDLT tumor recurrence including the sum of tumor size and number of tumors of 8 or more (P = 0.0004) and an NLR of 4 or more (P = 0.01). The 1- and 3- year recurrence-free survival rates in the recipients who had both risk factors were 30.0% and 15.0%, respectively. Conclusion: LDLT should not be performed for patients who have both independent risk factors after any treatments for HCC.

AB - Aim: Hepatocellular carcinoma (HCC) is primarily treated with hepatic resection and/or locoregional therapy. When HCC recurs and further treatment is no longer possible owing to poor liver function, liver transplantation (LT) or living-donor LT (LDLT) is considered. The aim of this study was to clarify risk factors for tumor recurrence after LDLT in patients with recurrent HCC. Methods: The study comprised 104 patients who had undergone LDLT because of end-stage liver disease with recurrent HCC. The recurrence-free survival rates after the LDLT were calculated. Risk factors for tumor recurrence were identified. Results: The 1-, 3- and 5-year recurrence-free survival rates were 89.6%, 80.3% and 78.4%, respectively. By univariate analysis, the factors affecting recurrence-free survival were the sum of the largest tumor size and number of tumors of 8 or more (P<0.0001), des-γ-carboxy prothrombin of more than 300mAU/mL (P = 0.0001), and a neutrophil-to-lymphocyte ratio (NLR) of 4 or more (P = 0.0002), α-fetoprotein of more than 400ng/mL (P = 0.0001) and bilobar tumor distribution (P = 0.046). A multivariate analysis identified independent risk factors for post-LDLT tumor recurrence including the sum of tumor size and number of tumors of 8 or more (P = 0.0004) and an NLR of 4 or more (P = 0.01). The 1- and 3- year recurrence-free survival rates in the recipients who had both risk factors were 30.0% and 15.0%, respectively. Conclusion: LDLT should not be performed for patients who have both independent risk factors after any treatments for HCC.

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U2 - 10.1111/hepr.12016

DO - 10.1111/hepr.12016

M3 - Article

C2 - 23190306

AN - SCOPUS:84879732245

VL - 43

SP - 709

EP - 716

JO - Hepatology Research

JF - Hepatology Research

SN - 1386-6346

IS - 7

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