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Cited by 485

The DOI matches its Crossref record; 33 of the 33 references it cites were found in a registry or an index.

Downstaging of hepatocellular cancer before liver transplant: Long‐term outcome compared to tumors within Milan criteria

Open access
Yao, Francis Y., Mehta, Neil, Flemming, Jennifer, Dodge, Jennifer, Hameed, Bilal, Fix, Oren, Hirose, Ryutaro, Fidelman, Nicholas, Kerlan, Robert K., Roberts, John P.·2015·Hepatology
DOI 10.1002/hep.27752
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Abstract

We report on the long‐term intention‐to‐treat (ITT) outcome of 118 patients with hepatocellular carcinoma (HCC) undergoing downstaging to within Milan/United Network for Organ Sharing T2 criteria before liver transplantation (LT) since 2002 and compare the results with 488 patients listed for LT with HCC meeting T2 criteria at listing in the same period. The downstaging subgroups include 1 lesion >5 and ≤8 cm (n = 43), 2 or 3 lesions at least one >3 and ≤5 cm with total tumor diameter ≤8 cm (n = 61), or 4‐5 lesions each ≤3 cm with total tumor diameter ≤8 cm (n = 14). In the downstaging group, 64 patients (54.2%) had received LT and 5 (7.5%) developed HCC recurrence. Two of the five patients with HCC recurrence had 4‐5 tumors at presentation. The 1‐ and 2‐year cumulative probabilities for dropout (competing risk) were 24.1% and 34.2% in the downstaging group versus 20.3% and 25.6% in the T2 group (P = 0.04). Kaplan‐Meier's 5‐year post‐transplant survival and recurrence‐free probabilities were 77.8% and 90.8%, respectively, in the downstaging group versus 81% and 88%, respectively, in the T2 group (P = 0.69 and P = 0.66, respectively). The 5‐year ITT survival was 56.1% in the downstaging group versus 63.3% in the T2 group (P = 0.29). Factors predicting dropout in the downstaging group included pretreatment alpha‐fetoprotein ≥1,000 ng/mL (multivariate hazard ratio [HR]: 2.42;P = 0.02) and Child's B versus Child's A cirrhosis (multivariate HR: 2.19;P = 0.04).Conclusion: Successful downstaging of HCC to within T2 criteria was associated with a low rate of HCC recurrence and excellent post‐transplant survival, comparable to those meeting T2 criteria without downstaging. Owing to the small number of patients with 4‐5 tumors, further investigations are needed to confirm the efficacy of downstaging in this subgroup. (H epatology 2015;61:1968–1977)

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Metadata

Authors
Yao, F. Y., Mehta, N., Flemming, J., Dodge, J., Hameed, B., Fix, O., Hirose, R., Fidelman, N., Kerlan, R. K., & Roberts, J. P.
Venue
Hepatology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-03-20
Volume
61
Issue
6
Pages
1968-1977
ISSN
  • 0270-9139 (ISSN-L)
  • 1527-3350
DOI
10.1002/hep.27752
OpenAlex
W1881850874
Cited by
485
References
33
FWCI
19.96
Type
journal article
Language
en
Open access
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CoChat. (2026). Citation check: Downstaging of hepatocellular cancer before liver transplant: Long‐term outcome compared to tumors within Milan criteria. https://app.cochat.ai/papers/10.1002/hep.27752
The paper
Yao, F. Y., Mehta, N., Flemming, J., Dodge, J., Hameed, B., Fix, O., Hirose, R., Fidelman, N., Kerlan, R. K., & Roberts, J. P. (2015). Downstaging of hepatocellular cancer before liver transplant: Long‐term outcome compared to tumors within Milan criteria. Hepatology. https://doi.org/10.1002/hep.27752

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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