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目的评价米兰标准、UCSF标准、Up-to-seven标准作为肝癌切除术后复发补救性肝移植适应症选择标准的有效性。方法回顾性分析本治疗组自1999年6月至2011年6月间实施的724例肝癌肝脏移植病例数据,其中包括107例肝癌切除术后复发行补救性肝移植术病例,对不同选择标准在各组病例的生存率进行统计分析。结果对于首选肝脏移植患者米兰标准、UCSF标准、Up-to-seven标准具有良好的一致性,5年生存率分别为76.2%,75.5%,73.4%。对于补救性肝脏移植,米兰标准、UCSF标准具有与首选肝脏移植一致的有效性,受者术后5年生存率分别83.1%,72.6%;而Up-to-seven标准则不具有一致的有效性,符合该标准的补救性肝脏移植受者5年生存率仅为49.9%,不符合Up-to-seven标准补救性肝脏移植受者的5年生存率为49.4%,二者无统计学差异。结论米兰标准、UCSF标准对于肝癌切除术后复发补救性肝移植适应症的选择具有较好的有效性,Up-to-seven标准有效性则较低;对于补救性肝癌肝移植应进行三维变量的标准选择,包括首次肝切除时肝癌数据、补救性肝脏移植评估时复发肝癌数据以及肝癌切除术后复发的时间间隔。
Objective To evaluate the validity of the Milan criteria, the UCSF criteria and the Up-to-seven criteria as the selection criterion for the indications of recurrent and conservative liver transplantation after resection of liver cancer. Methods A retrospective analysis of the treatment group from June 1999 to June 2011 between the implementation of 724 cases of liver cancer liver transplantation data, including 107 cases of recurrent liver cancer resection after liver transplantation cases, the different selection criteria in the The survival rates of each group were statistically analyzed. Results There was a good agreement between the UCSF standard and the Up-to-seven standard for the first choice liver transplant patients. The 5-year survival rates were 76.2%, 75.5% and 73.4% respectively. In the case of salvage liver transplantation, the UCSF standard has the same efficacy as the primary liver transplantation, with a 5-year survival rate of 83.1% and 72.6%, respectively, while the Up-to-seven standard does not have consistent efficacy . The 5-year survival rate of the recipients who met the standard for liver transplant recipients was only 49.9%. The 5-year survival rate of those who did not meet the Up-to-seven standard liver transplant recipients was 49.4%. There was no significant difference between the two groups. Conclusions The Milan standard and UCSF standard are effective for the selection of indications of recalcitrant liver transplantation after resection of liver cancer, while the validity of Up-to-seven standard is low. For three-dimensional liver transplantation of liver cancer, three-dimensional Criteria include liver cancer data on first hepatectomy, recurrence of liver cancer at the time of recuperative liver transplant assessment, and time to recurrence after hepatectomy.