日本肝细胞癌活体肝移植标准：全国队列研究。
Japanese living donor liver transplantation criteria for hepatocellular carcinoma: nationwide cohort study.
发表日期：2024 Jul 02
作者：
Masahiro Ohira, Gaku Aoki, Yasushi Orihashi, Kenichi Yoshimura, Takeo Toshima, Etsuro Hatano, Susumu Eguchi, Taizo Hibi, Kiyoshi Hasegawa, Yuzo Umeda, Takuya Hashimoto, Yasushi Hasegawa, Shuji Nobori, Yasuhiro Ogura, Hiroyuki Nitta, Hiroto Egawa, Hidetoshi Eguchi, Yasutsugu Takada, Yoshihide Ueda, Mureo Kasahara, Shigeyuki Kawachi, Yuji Soejima, Katsutoshi Tokushige, Hiroaki Nagano, Hironori Haga, Takumi Fukumoto, Satoshi Mochida, Koji Umeshita, Hideki Ohdan,
来源：
BJS Open
摘要：
使用国家数据验证肝细胞癌活体肝移植的扩展标准非常重要。本研究的目的是评估日本新的肝细胞癌患者活体肝移植标准的有效性，并使用日本国家数据集确定与不良预后相关的因素。研究人群包括接受活体肝移植的患者2010 年至 2018 年间，日本 37 个中心针对肝细胞癌进行了研究。在一项全国范围的调查中，根据日本新的标准，在将适应症扩展到超出范围时应用 5-5-500 规则，评估了总生存率和无复发生存率。米兰标准。使用 Cox 比例风险模型确定日本标准内的预后因素。日本标准以内（485 名患者）和超出（31 名患者）标准的患者的 5 年总生存率分别为 81% 和 58%，并且 5 年无复发存活率分别为77%和48%。符合米兰标准但不符合 5-5-500 规则的患者预后较差。对 474 名患者进行的多变量分析确定中性粒细胞与淋巴细胞比率大于或等于 5 以及肝切除史为独立危险因素。这项全国性调查证实了日本标准的有效性。日本标准中的不良预后因素包括中性粒细胞与淋巴细胞比率大于或等于 5 以及既往接受过肝切除术。© 作者 2024。由牛津大学出版社代表 BJS Foundation Ltd 出版。
Validating the expanded criteria for living donor liver transplantation for hepatocellular carcinoma using national data is highly significant. The aim of this study was to evaluate the validity of the new Japanese criteria for living donor liver transplantation for hepatocellular carcinoma patients and identify factors associated with a poor prognosis using the Japanese national data set.The study population comprised patients who underwent living donor liver transplantation for hepatocellular carcinoma at 37 centres in Japan between 2010 and 2018. In a nationwide survey, the overall survival and recurrence-free survival rates were evaluated based on the new Japanese criteria for applying the 5-5-500 rule when extending the indication beyond the Milan criteria. Prognostic factors within the Japanese criteria were determined using the Cox proportional hazards model.Patients within (485 patients) and beyond (31 patients) the Japanese criteria exhibited 5-year overall survival rates of 81% and 58% and 5-year recurrence-free survival rates of 77% and 48% respectively. Patients who met the Milan criteria, but not the 5-5-500 rule, had poorer outcomes. Multivariate analysis for 474 patients identified a neutrophil-to-lymphocyte ratio greater than or equal to 5 and a history of hepatectomy as independent risk factors.This nationwide survey confirms the validity of the Japanese criteria. The poor prognostic factors within the Japanese criteria include a neutrophil-to-lymphocyte ratio greater than or equal to 5 and previous hepatectomy.© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.