Background:Liver resection and local ablation are the only curative treatment for non-cirrhotic hepatocellular carcinoma(HCC).Few data exist concerning the prognosis of patients resected for non-cirrhotic HCC.The obje...Background:Liver resection and local ablation are the only curative treatment for non-cirrhotic hepatocellular carcinoma(HCC).Few data exist concerning the prognosis of patients resected for non-cirrhotic HCC.The objectives of this study were to determine the prognostic factors of recurrence-free survival(RFS)and overall survival(OS)and to develop a prognostication algorithm for non-cirrhotic HCC.Methods:French multicenter retrospective study including HCC patients with non-cirrhotic liver without underlying viral hepatitis:F0,F1 or F2 fibrosis.Results:A total of 467 patients were included in 11 centers from 2010 to 2018.Non-cirrhotic liver had a fibrosis score of F0(n=237,50.7%),F1(n=127,27.2%)or F2(n=103,22.1%).OS and RFS at 5 years were 59.2%and 34.5%,respectively.In multivariate analysis,microvascular invasion and HCC differentiation were prognostic factors of OS and RFS and the number and size were prognostic factors of RFS(P<0.005).Stratification based on RFS provided an algorithm based on size(P=0.013)and number(P<0.001):2 HCC with the largest nodule≤10 cm(n=271,Group 1);2 HCC with a nodule>10 cm(n=176,Group 2);>2 HCC regardless of size Conclusions:We developed a prognostication algorithm based on the number(≤or>2)and size(≤or>10 cm),which could be used as a treatment decision support concerning the need for perioperative therapy.In case of bifocal HCC,surgery should not be a contraindication.展开更多
We read with great interest the paper by Markmann et al.entitled“Impact of portable normothermic blood-based machine perfusion on outcomes of liver transplant:The OCS Liver PROTECT randomized clinical trial”(1).In t...We read with great interest the paper by Markmann et al.entitled“Impact of portable normothermic blood-based machine perfusion on outcomes of liver transplant:The OCS Liver PROTECT randomized clinical trial”(1).In this multicenter randomized clinical trial,the authors compared posttransplant outcomes for recipients who received donation after brainstem death(DBD)or donation after circulatory death(DCD)livers preserved using ischemic cold storage(ICS)or a portable normothermic machine perfusion(NMP)[Organ Care System(OCS)Liver].The primary endpoint was the incidence of early allograft dysfunction(EAD)as defined by Olthoff et al.criteria(2).The trial was methodologically designed to test both non-inferiority on the primary endpoint,and superiority if non-inferiority was achieved.This study was conducted from 2016 to 2019 at 20 US liver transplant programs.展开更多
文摘Background:Liver resection and local ablation are the only curative treatment for non-cirrhotic hepatocellular carcinoma(HCC).Few data exist concerning the prognosis of patients resected for non-cirrhotic HCC.The objectives of this study were to determine the prognostic factors of recurrence-free survival(RFS)and overall survival(OS)and to develop a prognostication algorithm for non-cirrhotic HCC.Methods:French multicenter retrospective study including HCC patients with non-cirrhotic liver without underlying viral hepatitis:F0,F1 or F2 fibrosis.Results:A total of 467 patients were included in 11 centers from 2010 to 2018.Non-cirrhotic liver had a fibrosis score of F0(n=237,50.7%),F1(n=127,27.2%)or F2(n=103,22.1%).OS and RFS at 5 years were 59.2%and 34.5%,respectively.In multivariate analysis,microvascular invasion and HCC differentiation were prognostic factors of OS and RFS and the number and size were prognostic factors of RFS(P<0.005).Stratification based on RFS provided an algorithm based on size(P=0.013)and number(P<0.001):2 HCC with the largest nodule≤10 cm(n=271,Group 1);2 HCC with a nodule>10 cm(n=176,Group 2);>2 HCC regardless of size Conclusions:We developed a prognostication algorithm based on the number(≤or>2)and size(≤or>10 cm),which could be used as a treatment decision support concerning the need for perioperative therapy.In case of bifocal HCC,surgery should not be a contraindication.
文摘We read with great interest the paper by Markmann et al.entitled“Impact of portable normothermic blood-based machine perfusion on outcomes of liver transplant:The OCS Liver PROTECT randomized clinical trial”(1).In this multicenter randomized clinical trial,the authors compared posttransplant outcomes for recipients who received donation after brainstem death(DBD)or donation after circulatory death(DCD)livers preserved using ischemic cold storage(ICS)or a portable normothermic machine perfusion(NMP)[Organ Care System(OCS)Liver].The primary endpoint was the incidence of early allograft dysfunction(EAD)as defined by Olthoff et al.criteria(2).The trial was methodologically designed to test both non-inferiority on the primary endpoint,and superiority if non-inferiority was achieved.This study was conducted from 2016 to 2019 at 20 US liver transplant programs.
