日本肝细胞癌活体肝移植标准:全国性队列研究。

IF 3.5 3区 医学 Q1 SURGERY
BJS Open Pub Date : 2024-07-02 DOI:10.1093/bjsopen/zrae079
Masahiro Ohira, Gaku Aoki, Yasushi Orihashi, Kenichi Yoshimura, Takeo Toshima, Etsuro Hatano, Susumu Eguchi, Taizo Hibi, Kiyoshi Hasegawa, Yuzo Umeda, Takuya Hashimoto, Yasushi Hasegawa, Shuji Nobori, Yasuhiro Ogura, Hiroyuki Nitta, Hiroto Egawa, Hidetoshi Eguchi, Yasutsugu Takada, Yoshihide Ueda, Mureo Kasahara, Shigeyuki Kawachi, Yuji Soejima, Katsutoshi Tokushige, Hiroaki Nagano, Hironori Haga, Takumi Fukumoto, Satoshi Mochida, Koji Umeshita, Hideki Ohdan
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引用次数: 0

摘要

背景:利用全国数据验证肝细胞癌活体肝移植扩大标准意义重大。本研究旨在评估日本肝细胞癌活体肝移植新标准的有效性,并利用日本全国数据集确定与不良预后相关的因素:研究对象包括2010年至2018年期间在日本37个中心接受肝细胞癌活体肝移植的患者。在一项全国范围的调查中,根据日本的新标准,在将适应症扩展到米兰标准之外时应用5-5-500规则,对总生存率和无复发生存率进行了评估。采用考克斯比例危险模型确定了日本标准中的预后因素:结果:符合日本标准的患者(485 例)和超出日本标准的患者(31 例)的 5 年总生存率分别为 81% 和 58%,5 年无复发生存率分别为 77% 和 48%。符合米兰标准但不符合 5-5-500 规则的患者预后较差。对474名患者进行的多变量分析发现,中性粒细胞与淋巴细胞比值大于或等于5以及有肝切除史是独立的风险因素:这项全国性调查证实了日本标准的有效性。日本标准中的不良预后因素包括中性粒细胞与淋巴细胞比值大于或等于 5 以及曾进行过肝切除术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Japanese living donor liver transplantation criteria for hepatocellular carcinoma: nationwide cohort study.

Background: Validating the expanded criteria for living donor liver transplantation for hepatocellular carcinoma using national data is highly significant. The aim of this study was to evaluate the validity of the new Japanese criteria for living donor liver transplantation for hepatocellular carcinoma patients and identify factors associated with a poor prognosis using the Japanese national data set.

Methods: The study population comprised patients who underwent living donor liver transplantation for hepatocellular carcinoma at 37 centres in Japan between 2010 and 2018. In a nationwide survey, the overall survival and recurrence-free survival rates were evaluated based on the new Japanese criteria for applying the 5-5-500 rule when extending the indication beyond the Milan criteria. Prognostic factors within the Japanese criteria were determined using the Cox proportional hazards model.

Results: Patients within (485 patients) and beyond (31 patients) the Japanese criteria exhibited 5-year overall survival rates of 81% and 58% and 5-year recurrence-free survival rates of 77% and 48% respectively. Patients who met the Milan criteria, but not the 5-5-500 rule, had poorer outcomes. Multivariate analysis for 474 patients identified a neutrophil-to-lymphocyte ratio greater than or equal to 5 and a history of hepatectomy as independent risk factors.

Conclusion: This nationwide survey confirms the validity of the Japanese criteria. The poor prognostic factors within the Japanese criteria include a neutrophil-to-lymphocyte ratio greater than or equal to 5 and previous hepatectomy.

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来源期刊
BJS Open
BJS Open SURGERY-
CiteScore
6.00
自引率
3.20%
发文量
144
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