title: Conditional disease-free survival after liver transplantation for hepatocellular carcinoma: A two-center experience.
abstract: Traditionally, survival estimates following liver transplantation (LT) of hepatocellular carcinoma (HCC) patients were calculated as survival from the surgery date, but future survival probabilities can change over time and conditional disease-free survival (CDFS) may provide patients and clinicians with more accurate prognostic information. This study aimed to assess CDFS in HCC patients after LT.Three hundred eighty-four HCC patients who underwent LT were included. Disease-free survival (DFS) was calculated using the Kaplan-Meier analysis. The 3-year CDFS, which represents the probability of remaining disease free for an additional 3 years, was calculated.1-, 3-, and 5-year DFS rates after LT were 69.9%, 45.8%, and 39.0 %, respectively. Based on the concept of CDFS, the probability of surviving an additional 3 years given that the patient was disease free at 1 year, 3 years, and 5 years were 58.4%, 76.9%, and 83.1%, respectively. Multivariate analysis indicated that larger tumor size (hazard ratio [HR], 1.509; 95% CI, 1.146-1.985; P = 0.003) was associated with poorer DFS. Patients with worse prognostic features at baseline demonstrated the greater increase in CDFS over time.Survival estimates following liver transplantation of HCC patients change according to survival time accrued since surgery. CDFS estimates improved dramatically over time especially among patients with worse prognostic features at the time of surgery. CDFS may be a useful tool in counseling patients with HCC, as it is a more accurate assessment of future survival for those patients who have already survived a certain amount of time.
authors: Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University Institute of Advanced Surgical Technology and Engineering, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province Department of Surgery, Huashan Hospital Cancer Metastasis Institute, Fudan University, Shanghai, P.R. China.
authors: Jian
authors: J
authors: Dong
authors: Ying
authors: Y
authors: Zhu
authors: Feng
authors: F
authors: Ma
authors: Yifang
authors: Y
authors: Ren
authors: Jianwen
authors: J
authors: Lu
authors: Zhengxin
authors: Z
authors: Wang
authors: Lunxiu
authors: L
authors: Qin
authors: Rongqian
authors: R
authors: Wu
authors: Yi
authors: Y
authors: Lv
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D002681:China; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012737:Sex Factors; D013997:Time Factors