机构:[1]Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China[2]Institute of Organ Transplantation, Zhejiang University, Hangzhou, China[3]Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China[4]NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou, China[5]Zhejiang University School of Medicine, Hangzhou, China[6]Department of Hepatobiliary and Pancreatic Surgery, Affiliated Lishui Hospital, Zhejiang University School of Medicine, Lishui, China[7]National Center for Healthcare Quality Management in Liver Transplant, Hangzhou, China[8]Graduate School, Nanjing University of Chinese Medicine, Nanjing, China[9]Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China[10]Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China四川大学华西医院[11]Department of Liver Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China[12]Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China浙江大学医学院附属第一医院[13]Department of Hepatobiliary and Pancreatic Surgery, Shulan Hospital of Hangzhou, Hangzhou, China
Background: Salvage liver transplantation (SLT) has been reported to be an efficient treatment option for patients with recurrent hepatocellular carcinoma (HCC) after liver resection (LR). However, for recipients who underwent liver transplantation (LT) due to recurrent HCC after LR in China, the selection criteria are not well established. Methods: In this study, data from the China Liver Transplant Registry (CLTR) of 4244 LT performed from January 2015 to December 2019 were examined, including 3,498 primary liver transplantation (PLT) and 746 SLT recipients. Propensity score matching (PSM) analysis was used to minimize between-group imbalances. The overall survival (OS) and disease-free survival (DFS) between PLT and SLT in recipients fulfilling the Milan or Hangzhou criteria were compared based on the multivariate analysis, nomograms were plotted to further classify the SLT group into low-and high-risk groups. Results: In this study, the 1-, 3-and 5-year OS and DFS of SLT recipients fulfilling Milan criteria (OS, P=0.01; DFS, P<0.001) or Hangzhou criteria (OS, P=0.03; DFS, P=0.003) were significantly reduced when compared to that of PLT group after PSM analysis. Independent risk factors, including preoperative transarterial chemoembolization (TACE), alpha fetoprotein (AFP) level, tumor maximum size and tumor total diameter were selected to draw a prognostic nomogram. The low-risk SLT recipients (1-year, 95.34%; 3-year, 84.26%; 5-year, 77.20%) showed a comparable OS with PLT recipients fulfilling Hangzhou criteria (P=0.107). Conclusions: An optimal nomogram model for prognosis stratification and clinical decision guidance of SLT was established. The low-risk SLT recipients based on the nomograms showed comparable survival with those fulfilling Hangzhou criteria in PLT group.
基金:
Youth Program of National Natural Science Foundation of China [82003248]; National Natural Science Foundation of China [81930016]; Key R&D Project of Zhejiang Province [2019C03050]; National Key Research and Development Program of China [2021YFA1100500]; Major Research Plan of the National Natural Science Foundation of China [92159202]
第一作者机构:[1]Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China[2]Institute of Organ Transplantation, Zhejiang University, Hangzhou, China[3]Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China[4]NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou, China
共同第一作者:
通讯作者:
通讯机构:[2]Institute of Organ Transplantation, Zhejiang University, Hangzhou, China[3]Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China[4]NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou, China[5]Zhejiang University School of Medicine, Hangzhou, China[7]National Center for Healthcare Quality Management in Liver Transplant, Hangzhou, China[10]Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China[11]Department of Liver Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China[12]Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China[13]Department of Hepatobiliary and Pancreatic Surgery, Shulan Hospital of Hangzhou, Hangzhou, China[*1]Zhejiang University School of Medicine, Hangzhou 310058, China[*2]Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.[*3]Department of Liver Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China.[*4]Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610044, China.
推荐引用方式(GB/T 7714):
Wang Kai,Gao Fengqiang,Dong Siyi,et al.A novel nomogram for prognosis stratification in salvage liver transplantation: a national-wide study with propensity score matching analysis in China[J].HEPATOBILIARY SURGERY AND NUTRITION.2023,12(6):854-867.doi:10.21037/hbsn-22-304.
APA:
Wang, Kai,Gao, Fengqiang,Dong, Siyi,Ding, Jialu,Dong, Libin...&Xu, Xiao.(2023).A novel nomogram for prognosis stratification in salvage liver transplantation: a national-wide study with propensity score matching analysis in China.HEPATOBILIARY SURGERY AND NUTRITION,12,(6)
MLA:
Wang, Kai,et al."A novel nomogram for prognosis stratification in salvage liver transplantation: a national-wide study with propensity score matching analysis in China".HEPATOBILIARY SURGERY AND NUTRITION 12..6(2023):854-867