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- 저자 : 유영경(Yung Kyung Yoo) (검색결과 1 건)
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이경근(Kyung Keun Lee),윤영철(Young Chul Youn),황정기(Jung Ki Hwang),박정현(Jung Hyun Park),김지일(Ji Il Kim),유영경(Yung Kyung Yoo),문인성(In Sung Moon),김동구(Dong Goo Kim) 한국간담췌외과학회 2009 한국간담췌외과학회지 Vol.13 No.3
Purpose : The purpose of this study was to evaluate the possibility of expanding the indication for living donor live transplantation (LDLT) for treatment of hepatocellular carcinoma(HCC), beyond the Milan criteria without compromising patient survival. Methods : This was a retrospective study of 5patients (36.4%) that had undergone LDLT, beyond the Milan criteria, among 143 patients with HCC. The study was conducted in aptients treated by the Department of Surgery, Catholic University of orea from Oct 2000 to May 2008. We evaluated the survival curve, prognostic factors for survival and compared survival between our new criteria and Milan criteria. Results : The 5 year patient survival and disease free survival rate in patients treated with LDLT beyond the Milan criteria were 50.2% and 61.9%, respectively. The prognostic factors affecting disease free survival and patient survival included serum AFP level, tumor size, vascular invasion, and lumor cell differentation on univariate analysis. In multivariate analysis, AFP (200 ng/mL), tumor size (7cm) and vascular invasion had significant influence on survival and disease free survival. According to our new criteria (size<7 cm, AFP <200 ng/mL), 88.1% of our patients were included compare to the 63.6% that would have been if limited to the Milan criteria. With both factors met, the survival was comparable to the survival of Milan criteria (63.7% on our criteria and 78.2% on Milan criteria at 5 years)(P=0.103). Conclusion : A tumor size <7cm and a AFP <200 ng/mL appear to be useful cut-off values, beyond that criteria required by Milan. An analysis according to our criteria showed an acceptable survival outcome. Further verification of these findings by a large volume or prospective study is required for widespread adoption of our new criteria.
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