title: [A retrospective cohort study regarding the effect of sirolimus-based immunosuppression protocol on the long-term survival of hepatocellular carcinoma patients after liver transplantation].
abstract: OBJECTIVE
  To evaluate the influence of sirolimus on the long-term survival of patients after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Clinic data of 165 consecutive patients who underwent OLT for HCC from February 2005 to March 2012 was analyzed retrospectively. Among them, 94 patients were treated with a sirolimus-based immunosuppressive protocol after OLT, while the other 71 patients with a FK506-based protocol. Postoperative survival time, survival, disease-free survival (DFS) and tumor recurrence rates between the two groups were compared.
  
  
  RESULTS
  The 2 groups were comparable in all clinicopathologic parameters. The sirolimus-based group had higher patient survival rates than the control group at 1-year (87% vs. 97%, P = 0.03), 2-year (80% vs. 88%), 3-year (76% vs. 85%) and 5-year (63% vs. 75%). The 1-year, 2-year, 3-year and 5-year recurrence rates were 12% vs. 3%, 17% vs. 9%, 21% vs. 9% (P = 0.04) and 31% vs. 16% (P = 0.03). Early and mid-HCC (I - II stage) of 131 cases (control group 61 cases, sirolimus-based group of 70 patients). The 1-year, 2-year, 3-year and 5-year survival rates were 90% vs. 97% , 80% vs. 90%, 78% vs. 86% and 65% vs. 82% (P = 0.04) and recurrence rates were 10% vs. 3%, 16% vs. 8%, 18% vs. 8% and 29% vs. 11% (P = 0.01).
  
  
  CONCLUSIONS
  The sirolimus-based immunosuppressive protocol reduce long-term postoperative recurrence rate and improve the survival rate of patients after OLT for HCC significantly (especially early-mid HCC).
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplatation Center, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Email: lsc620213@aliyun.com.
authors.forename: Shichun
authors.initials: S
authors.lastname: Lu
authors.forename: Menglong
authors.initials: M
authors.lastname: Wang
authors.forename: Jushan
authors.initials: J
authors.lastname: Wu
authors.forename: Dongdong
authors.initials: D
authors.lastname: Lin
authors.forename: Qingliang
authors.initials: Q
authors.lastname: Guo
authors.forename: Wei
authors.initials: W
authors.lastname: Lai
authors.forename: Daobing
authors.initials: D
authors.lastname: Zeng
authors.forename: Chuanyun
authors.initials: C
authors.lastname: Li
authors.forename: Yuan
authors.initials: Y
authors.lastname: Liu
authors.forename: Libo
authors.initials: L
authors.lastname: Sun
authors.forename: Dong
authors.initials: D
authors.lastname: Yan
authors.forename: Ning
authors.initials: N
authors.lastname: Li
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D020123:Sirolimus / Q000627:therapeutic use*; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus