title: Five-year survival after monotherapy for hepatocellular carcinoma in the setting of cirrhosis.
abstract: The purpose of this study was to evaluate the long-term results with monotherapy for hepatocellular carcinoma (HCC) in the setting of cirrhosis. We reviewed data of 14 patients who survived for at least 5 years after performance of liver resection (n = 1), transarterial chemoembolization (TACE, n = 3), or liver transplantation (OLT, n = 19). Eight patients were within the Milan criteria, whereas the remaining 6 were beyond the criteria. Tumor stages according to the UICC were I (n = 8), II (n = 5), and IIIA (n = 1). Vascular invasion was not detected in any patient. The HCCs recurred in 2 patients, at 81 and 48 months' posttransplant. Sites of recurrence were the intrathoracic lymph nodes in the first case, and lungs in the second case. Treatment of recurrence included chemotherapy in the first case and local resection in the second case. Both patients died at 98 and 64 months postoperation (ie, 17 and 16 months, respectively, after the diagnosis of the recurrence). A third patient died of nontumor-related causes at 69 months after his first TACE. Currently, 11 patients are alive with a median survival of 70 months (range, 63-144 months). The alpha-fetoprotein level was demonstrated to be prognostic of recurrence by discriminant function analysis. In conclusion, OLT provided the best long-term results as monotherapy for HCC in the setting of cirrhosis.
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, University Hospital, Essen, Germany; Organ Transplant Unit, Hippocration University Hospital, Thessaloniki, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Fouzas
authors.forename: G C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: G
authors.initials: G
authors.lastname: Sgourakis
authors.forename: N
authors.initials: N
authors.lastname: Drühe
authors.forename: J
authors.initials: J
authors.lastname: Wohlschlaeger
authors.forename: E P
authors.initials: EP
authors.lastname: Molmenti
authors.forename: C E
authors.initials: CE
authors.lastname: Broelsch
authors.forename: H
authors.initials: H
authors.lastname: Lang
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D015996:Survival Rate; D017741:Survivors; D013997:Time Factors; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins