Strategic International Session3(JSGS・JSGE・JSH)
Sat. November 4th   9:00 - 11:30   Room 9: Portopia Hotel Main Building Kairaku 3
Clinical course of patients with liver cancer and incidental bile duct cancer after orthotopic liver transplantation.
Akinobu Takaki1, Yuzo Umeda2, Motoyuki Otsuka1
1Department of Gastroenterology, Okayama University, 2Department of Hepato-Biliary-Pancreatic Surgery, Okayama University
Objective: To investigate the clinical course of hepatocellular carcinoma (HCC) and incidental intra- or extra- hepatic cholangiocellular carcinoma (CCC) after orthotopic liver transplantation (OLT).
Methods: One hundred eight patients diagnosed with HCC (n=103) or CCC (n=5) via radiological findings before OLT and the clinical courses or pathological findings after OLT were investigated. The clinical course after OLT was investigated according to the Milan criteria (within 82, over 21), 5-5-500 rule (within 90, over 13), and the pathological findings. The pathological findings were as follows, no viable cancer cells (n=16; 15%), well differentiated HCC (n=21; 19%), moderately differentiated HCC (n=62; 57%), poorly differentiated HCC (n=4; 3.7%), and CCC (n=5; 4.6%).
Results: The 10-year survival rates after OLT of patients within and over the Milan criteria were 79% and 59%, respectively, while those of patients within and over the 5-5-500 rule were 76% and 69%. The 10-year survival rate according to the histological findings were as follows: no viable cancer cells, 86%; well differentiated HCC, 65%; and moderately differentiated HCC, 73%. Survival rate of patients with CCC was extremely bad, with a one-year survival rate of 40%. Four of the five CCC patients showed cancer recurrence. One patient without recurrence of CCC died with infection after six months.
Conclusion: Patients with CCC showed extremely poor survival after OLT.
Index Term 1: cholangiocellular carcinoma
Index Term 2: liver transplantation
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