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 Biofilm discovery suggests new way to prevent dangerous infections
23.05.2017 | University of Texas at Austin

nachricht Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care

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: Can the immune system be boosted against Staphylococcus aureus by delivery of messenger RNA?

Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.

Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....

Im Focus: A quantum walk of photons

Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.

The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....

Im Focus: Turmoil in sluggish electrons’ existence

An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.

We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Marine Conservation: IASS Contributes to UN Ocean Conference in New York on 5-9 June

24.05.2017 | Event News

AWK Aachen Machine Tool Colloquium 2017: Internet of Production for Agile Enterprises

23.05.2017 | Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

 
Latest News

How herpesviruses win the footrace against the immune system

26.05.2017 | Life Sciences

Water forms 'spine of hydration' around DNA, group finds

26.05.2017 | Life Sciences

First Juno science results supported by University of Leicester's Jupiter 'forecast'

26.05.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>