A Comparison Of The Treatment Effect Of Comprehensive Treatment And Liver Transplantation For Hepatocellular Carcinoma Exceeding Milan Criteria

Objective1、To analyze and compare the treatment effects of comprehensivetreatments and liver transplantation for hepatocellular carcinomas(HCC) whichexceed Milan criteria.2、 Analysis of effect of comprehensive treatmentof HCC liver transplantation。Methods Retrospective analysis of the157cases ofHCC receiving comprehensive treatments(99patient) and liver transplantation(58patient) in our hospital from2006to2010. The median survival time and surialalanalysis was carried out by using Kaplan-Meier method, Log-Rank test was used tocaculated the p value, which was according to the hierarchical cases of the liver tumorsize, number, a tire protein (AFP) and Shanghai standard.Results1、The survival rate was significantly increased by the treatment of livertransplantation in HCC (p<0.05)，when liver tumor>5cm and≤cm, the number≤3, AFP400ug/L. There was no significant difference survival rate between twogroups (p>0.05)，when the opposite.2. The median survival time between HCC treated withs comprehensivetreatment and liver transplantation were18.0±1.15and23.4±4.44months.,The3yearssurvival rates were18.2±3.9%and39.7±6.4%, The survival rate was significantlyincreased by the treatment of liver transplantation in HCC (p<0.05). The mediansurvival time of comprehensive treatment and liver transplantation gronp is20.0±1.173and36.0±0.00months in HCC patients exceeding Milan criteria butcomplying with Shanghai Criteria, the3year survival rate is25.0±6.4%and68.0±9.3%, there was significant difference in survival rates between two groups (p<0.05). The median survival time of comprehensive treatment and liver transplantationgronp is16.0±1.78and18.0±2.45months in HCC patients exceeding ShanghaiCriterias, The3year survival rate is11.5±4.4%and18.2.0±6.7%, there was nosignificant difference survival rate between two groups (p>0.05).3. The3years survival rates between HCC treated withs downstagin and notwere63.2±11.1%and28.2±.2%, the survival rate was significantly increased bydownstagin (p<0.05). The tumor recurrence had no significant difference betweenthe two gronps(48、2%VS64.1%).When liver cancer recurrence, the survival rate wassignificantly increased by anti-tumor therapy(p<0.05),the3year survival rate ofanti-tumor therapy and not is40.0±11.0%and5.6±5.4%.Conclusion1. Liver transplantation is superior to comprehensive treatment whenliver tumor>5cm and≤9cm, the number≤3, AFP≤400ug/L. when the opposite,there was no significant difference between two groups.2. Liver transplantationcompared with comprehensive treatment showed hihger long term survial rates inHCC patients complying with Shanghai Criteria. But the survial rates showed nodifference between two treatments in HCC patients exceeding Shanghai criteria.3. The effect of Liver transplantation can be improved for patients exceeding Milancriteria with downstagin and anti-tumor therapy after cancer recurrence.