Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Liver transplants result in excellent survival rates for patients with liver cancer

28.10.2003


In the first national study to examine survival among liver transplant patients with advanced hepatocellular carcinoma (HCC), researchers found excellent five-year survival results, with a steady improvement over the last decade. Hepatocellular carcinoma, also known as hepatoma, or cancer of the liver, is a common cancer worldwide, with more than one million new cases diagnosed each year and a median life expectancy of six to nine months. Most hepatoma patients have cirrhosis, a risk factor of hepatoma, and are inoperable because of tumor size, location or severity of underlying liver disease. Results of this study will be reported online in the Journal of Clinical Oncology.



"This study shows that we can achieve excellent survival with liver transplantation among patients with hepatoma, confirming similar results reported by single center studies," said Paul J. Thuluvath, MD, senior author and Associate Professor in the Department of Medicine at Johns Hopkins University School of Medicine. "These findings are particularly reassuring for patients with tumors that cannot be surgically removed, which comprise more than 80 % of HCC patients."

The primary objective of the study was to determine survival in an unselected patient population who had liver transplantation for HCC. Using the United Network for Organ Sharing (UNOS) database, researchers collected data on 48,887 patients who underwent liver transplantation in the United States between 1987 and 2001. Patients were excluded if they had undergone multiple organ transplantation, retransplantation, were less than 18 years of age, or lacked survival information.


Of the remaining patients included in the final analysis, 985 had liver transplantation for hepatocellular carcinoma (hepatoma group) and 33,339 patients had liver transplantation for other reasons (control group). Both the hepatoma and control groups were divided into three different five-year time periods: 1987 – 1991, 1992 – 1996, and 1997 – 2001.

Researchers found significant and steady improvement in survival over time among liver transplant patients with HCC, particularly in the last five years. Five-year survival improved from 25.3 percent during 1987-1991 to 47 percent during 1992-1996, and 61.1 percent during 1996-2001.

"Although the survival is low in patients with hepatoma as compared to patients who had transplantation for non-malignant liver conditions, excellent five-year survival rates in patients with HCC suggest that liver transplantation is the treatment of choice in patients with advanced cirrhosis and HCC," said Dr. Thuluvath.

Researchers also wanted to see whether the ’Milan criteria’ for selecting HCC patients for liver transplantation, incorporated by many transplant centers as a ’guideline’ after a landmark study in 1996, had any indirect effect on patient survival among the 1997-2001 group. Milan criteria require that tumors be less than five centimeters, less than three centimeters if there are one to three tumors, and no invasion of blood vessels or lymph nodes.

Study authors noted that the excellent survival results between 1997 and 2001 may be a result of careful patient selection based on the improved Milan criteria, but cautioned that this finding is based on speculation.

Researchers also noted several limitations to the study. Because they examined a large database and did not have information on detailed staging of individual patients and the actual criteria used at the time of liver transplant, critical information about how patients were selected, tumor size and histology, and the extent of a patient’s liver disease remains unknown.

In addition, given the prevalence of hepatoma worldwide and the limited supply of organs, researchers pointed to the need for better surveillance, detection and prevention of hepatoma and underlying cirrhosis, and universal HBV vaccination, particularly for countries where organ transplantation is not always an option.

"The outcome of liver transplantation in patients with hepatocellular carcinoma in the US between 1998 and 2001: 5-year survival has improved significantly with time." Paul J. Thuluvath, M.D. et al, Johns Hopkins University School of Medicine, Baltimore, Maryland.


The Journal of Clinical Oncology is the semi-monthly peer-reviewed journal of the American Society of Clinical Oncology (ASCO), the world’s leading professional society representing physicians who treat people with cancer.

ATTRIBUTION TO THE JOURNAL OF CLINICAL ONCOLOGY IS REQUESTED IN ALL NEWS COVERAGE.

For the full text of any JCO article, contact 703-519-1423 or 212-584-5014. The JCO News Digest is also distributed via email. Please let us know if you would like to be added to our email distribution list.

Carrie Housman | EurekAlert!

More articles from Health and Medicine:

nachricht An ounce of prevention: Research advances on 'scourge' of transplant wards
28.08.2015 | University of Wisconsin-Madison

nachricht Hypoallergenic parks: Coming soon?
27.08.2015 | American Society of Agronomy

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: OU astrophysicist and collaborators find supermassive black holes in quasar nearest Earth

A University of Oklahoma astrophysicist and his Chinese collaborator have found two supermassive black holes in Markarian 231, the nearest quasar to Earth, using observations from NASA's Hubble Space Telescope.

The discovery of two supermassive black holes--one larger one and a second, smaller one--are evidence of a binary black hole and suggests that supermassive...

Im Focus: What would a tsunami in the Mediterranean look like?

A team of European researchers have developed a model to simulate the impact of tsunamis generated by earthquakes and applied it to the Eastern Mediterranean. The results show how tsunami waves could hit and inundate coastal areas in southern Italy and Greece. The study is published today (27 August) in Ocean Science, an open access journal of the European Geosciences Union (EGU).

Though not as frequent as in the Pacific and Indian oceans, tsunamis also occur in the Mediterranean, mainly due to earthquakes generated when the African...

Im Focus: Self-healing landscape: landslides after earthquake

In mountainous regions earthquakes often cause strong landslides, which can be exacerbated by heavy rain. However, after an initial increase, the frequency of these mass wasting events, often enormous and dangerous, declines, in fact independently of meteorological events and aftershocks.

These new findings are presented by a German-Franco-Japanese team of geoscientists in the current issue of the journal Geology, under the lead of the GFZ...

Im Focus: FIC Proteins Send Bacteria Into Hibernation

Bacteria do not cease to amaze us with their survival strategies. A research team from the University of Basel's Biozentrum has now discovered how bacteria enter a sleep mode using a so-called FIC toxin. In the current issue of “Cell Reports”, the scientists describe the mechanism of action and also explain why their discovery provides new insights into the evolution of pathogens.

For many poisons there are antidotes which neutralize their toxic effect. Toxin-antitoxin systems in bacteria work in a similar manner: As long as a cell...

Im Focus: Fraunhofer IPA develops prototype of intelligent care cart

It comes when called, bringing care utensils with it and recording how they are used: Fraunhofer IPA is developing an intelligent care cart that provides care staff with physical and informational support in their day-to-day work. The scientists at Fraunhofer IPA have now completed a first prototype. In doing so, they are continuing in their efforts to improve working conditions in the care sector and are developing solutions designed to address the challenges of demographic change.

Technical assistance systems can improve the difficult working conditions in residential nursing homes and hospitals by helping the staff in their work and...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Networking conference in Heidelberg for outstanding mathematicians and computer scientists

20.08.2015 | Event News

Scientists meet in Münster for the world’s largest Chitin und Chitosan Conference

20.08.2015 | Event News

Large agribusiness management strategies

19.08.2015 | Event News

 
Latest News

Interstellar seeds could create oases of life

28.08.2015 | Physics and Astronomy

An ounce of prevention: Research advances on 'scourge' of transplant wards

28.08.2015 | Health and Medicine

Fish Oil-Diet Benefits May be Mediated by Gut Microbes

28.08.2015 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>