Orthotopic liver transplantation for preoperative early-stage hepatocellular carcinoma

C. K. Tan, Gregory James Gores, J. L. Steers, M. K. Porayko, J. E. Hay, Jorge Rakela, R. H. Wiesner, R. A F Krom

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: To report our experience with orthotopic liver transplantation (OLT) for highly selected patients with early-stage hepatocellular carcinoma (HCC). Design: We retrospectively analyzed the demographic, clinical, pathologic, and survival data on 21 patients with HCC who underwent OLT at the Mayo Clinic between 1985 and 1993. Material and Methods: The 21 patients were categorized into three groups: (1) those with incidental HCC (no evidence of HCC preoperatively), (2) those with a unicentric hepatic lesion without vascular invasion, and (3) those with an increased serum α- fetoprotein (AFP) concentration but no detectable mass lesion in the liver. Results: For the seven patients with incidental HCC, the 2-year disease-free survival was 68.5%. For the eight patients with a mass lesion, the 2-year disease-free survival was only 50%. Operative staging revealed more advanced stage disease than had been found on preoperative assessment in five of these eight patients. For the six patients with an increased serum AFP value but no mass lesion, the 2-year disease-free survival was 80%. Tumor recurrence was the major cause of all deaths in this series. Conclusion: Disease-free survival for patients with radiographic early-stage HCC was suboptimal because of understaging of the disease preoperatively. In contrast, our initial experience with OLT for patients with an increased serum AFP value in the absence of a mass lesion in the liver was favorable.

Original languageEnglish (US)
Pages (from-to)509-514
Number of pages6
JournalMayo Clinic Proceedings
Volume69
Issue number6
StatePublished - 1994

Fingerprint

Liver Transplantation
Hepatocellular Carcinoma
Disease-Free Survival
Liver
Serum
Fetal Proteins
Blood Vessels
Cause of Death
Demography
Recurrence
Survival

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tan, C. K., Gores, G. J., Steers, J. L., Porayko, M. K., Hay, J. E., Rakela, J., ... Krom, R. A. F. (1994). Orthotopic liver transplantation for preoperative early-stage hepatocellular carcinoma. Mayo Clinic Proceedings, 69(6), 509-514.

Orthotopic liver transplantation for preoperative early-stage hepatocellular carcinoma. / Tan, C. K.; Gores, Gregory James; Steers, J. L.; Porayko, M. K.; Hay, J. E.; Rakela, Jorge; Wiesner, R. H.; Krom, R. A F.

In: Mayo Clinic Proceedings, Vol. 69, No. 6, 1994, p. 509-514.

Research output: Contribution to journalArticle

Tan, CK, Gores, GJ, Steers, JL, Porayko, MK, Hay, JE, Rakela, J, Wiesner, RH & Krom, RAF 1994, 'Orthotopic liver transplantation for preoperative early-stage hepatocellular carcinoma', Mayo Clinic Proceedings, vol. 69, no. 6, pp. 509-514.
Tan, C. K. ; Gores, Gregory James ; Steers, J. L. ; Porayko, M. K. ; Hay, J. E. ; Rakela, Jorge ; Wiesner, R. H. ; Krom, R. A F. / Orthotopic liver transplantation for preoperative early-stage hepatocellular carcinoma. In: Mayo Clinic Proceedings. 1994 ; Vol. 69, No. 6. pp. 509-514.
@article{c0423fa35ac34f1eaca7ea96407d4aed,
title = "Orthotopic liver transplantation for preoperative early-stage hepatocellular carcinoma",
abstract = "Objective: To report our experience with orthotopic liver transplantation (OLT) for highly selected patients with early-stage hepatocellular carcinoma (HCC). Design: We retrospectively analyzed the demographic, clinical, pathologic, and survival data on 21 patients with HCC who underwent OLT at the Mayo Clinic between 1985 and 1993. Material and Methods: The 21 patients were categorized into three groups: (1) those with incidental HCC (no evidence of HCC preoperatively), (2) those with a unicentric hepatic lesion without vascular invasion, and (3) those with an increased serum α- fetoprotein (AFP) concentration but no detectable mass lesion in the liver. Results: For the seven patients with incidental HCC, the 2-year disease-free survival was 68.5{\%}. For the eight patients with a mass lesion, the 2-year disease-free survival was only 50{\%}. Operative staging revealed more advanced stage disease than had been found on preoperative assessment in five of these eight patients. For the six patients with an increased serum AFP value but no mass lesion, the 2-year disease-free survival was 80{\%}. Tumor recurrence was the major cause of all deaths in this series. Conclusion: Disease-free survival for patients with radiographic early-stage HCC was suboptimal because of understaging of the disease preoperatively. In contrast, our initial experience with OLT for patients with an increased serum AFP value in the absence of a mass lesion in the liver was favorable.",
author = "Tan, {C. K.} and Gores, {Gregory James} and Steers, {J. L.} and Porayko, {M. K.} and Hay, {J. E.} and Jorge Rakela and Wiesner, {R. H.} and Krom, {R. A F}",
year = "1994",
language = "English (US)",
volume = "69",
pages = "509--514",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "6",

}

TY - JOUR

T1 - Orthotopic liver transplantation for preoperative early-stage hepatocellular carcinoma

AU - Tan, C. K.

AU - Gores, Gregory James

AU - Steers, J. L.

AU - Porayko, M. K.

AU - Hay, J. E.

AU - Rakela, Jorge

AU - Wiesner, R. H.

AU - Krom, R. A F

PY - 1994

Y1 - 1994

N2 - Objective: To report our experience with orthotopic liver transplantation (OLT) for highly selected patients with early-stage hepatocellular carcinoma (HCC). Design: We retrospectively analyzed the demographic, clinical, pathologic, and survival data on 21 patients with HCC who underwent OLT at the Mayo Clinic between 1985 and 1993. Material and Methods: The 21 patients were categorized into three groups: (1) those with incidental HCC (no evidence of HCC preoperatively), (2) those with a unicentric hepatic lesion without vascular invasion, and (3) those with an increased serum α- fetoprotein (AFP) concentration but no detectable mass lesion in the liver. Results: For the seven patients with incidental HCC, the 2-year disease-free survival was 68.5%. For the eight patients with a mass lesion, the 2-year disease-free survival was only 50%. Operative staging revealed more advanced stage disease than had been found on preoperative assessment in five of these eight patients. For the six patients with an increased serum AFP value but no mass lesion, the 2-year disease-free survival was 80%. Tumor recurrence was the major cause of all deaths in this series. Conclusion: Disease-free survival for patients with radiographic early-stage HCC was suboptimal because of understaging of the disease preoperatively. In contrast, our initial experience with OLT for patients with an increased serum AFP value in the absence of a mass lesion in the liver was favorable.

AB - Objective: To report our experience with orthotopic liver transplantation (OLT) for highly selected patients with early-stage hepatocellular carcinoma (HCC). Design: We retrospectively analyzed the demographic, clinical, pathologic, and survival data on 21 patients with HCC who underwent OLT at the Mayo Clinic between 1985 and 1993. Material and Methods: The 21 patients were categorized into three groups: (1) those with incidental HCC (no evidence of HCC preoperatively), (2) those with a unicentric hepatic lesion without vascular invasion, and (3) those with an increased serum α- fetoprotein (AFP) concentration but no detectable mass lesion in the liver. Results: For the seven patients with incidental HCC, the 2-year disease-free survival was 68.5%. For the eight patients with a mass lesion, the 2-year disease-free survival was only 50%. Operative staging revealed more advanced stage disease than had been found on preoperative assessment in five of these eight patients. For the six patients with an increased serum AFP value but no mass lesion, the 2-year disease-free survival was 80%. Tumor recurrence was the major cause of all deaths in this series. Conclusion: Disease-free survival for patients with radiographic early-stage HCC was suboptimal because of understaging of the disease preoperatively. In contrast, our initial experience with OLT for patients with an increased serum AFP value in the absence of a mass lesion in the liver was favorable.

UR - http://www.scopus.com/inward/record.url?scp=0028358951&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028358951&partnerID=8YFLogxK

M3 - Article

C2 - 7514702

AN - SCOPUS:0028358951

VL - 69

SP - 509

EP - 514

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 6

ER -