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Comparative analysis of outcomes after liver resection and liver transplantation for early stages hepatocellular carcinoma in HIV-infected patients. An intention-to-treat analysis.

HIV 感染患者早期肝细胞癌肝切除术和肝移植术后结局的比较分析。意向治疗分析。

  • 影响因子:2.92
  • DOI:10.1016/j.hpb.2019.10.014
  • 作者列表:"Golse N","Duarte P","Fontana A","Bündchen C","Karam V","Allard MA","Pittau G","Ciacio O","Duclos-Vallée JC","Sa Cunha A","Castaing D","Cherqui D","Adam R","Samuel D","Vibert E
  • 发表时间:2020-06-01
Abstract

BACKGROUND:To address the results of resection for hepatocellular carcinoma (HCC) in human immunodeficiency virus (HIV)-carriers, and to compare them against survival after liver transplantation (LT). METHODS:All patients with HIV and HCC listed for LT (candidates = LTc+) or resection (LR+) between 2000 and 2017 in our centre were analysed and compared for overall survival (OS) and disease-free survival (DFS). RESULTS:The LTc + group (n = 43) presented with higher MELD scores and more advanced portal hypertension and HCC stages than LR + group (n = 15). One-, 3- and 5-year intention-to-treat survival rates were: 81%, 60% and 44%, versus 86%, 58% and 58% in the LTc+ and LR + groups, respectively (p = 0.746). Eleven LTc + patients dropped out. After LT, OS was 81%, 68% and 59% (no difference with LR + group; p = 0.844). There tended to be better DFS after LT, reaching 78%, 68% and 56% versus 53%, 33% and 33% in the LR + group (p = 0.062). CONCLUSION:This was the largest series of resections for HCC in HIV + patients and the first intention-to-treat analysis. Although LT and resection do not always concern the same population, they enable equivalent survival. At the price of higher recurrence rate, resection could be integrated in the global armoury of liver surgeons.

摘要

背景: 探讨人类免疫缺陷病毒 (HIV) 携带者肝细胞癌 (HCC) 切除术的结果,并将其与肝移植 (LT) 后的生存率进行比较。 方法: 分析并比较我们中心 2000 年至 2017 年间所有 HIV 和 HCC 患者的 LT (候选者 = LTc +) 或切除 (LR +) 总生存率 (OS) 和无病生存期 (DFS)。 结果: 与 LR + 组 (n = 15) 相比,LTc + 组 (n = 43) 表现出更高的 MELD 评分和更晚期的门静脉高压和 HCC 分期。1 、 3 和 5 年意向治疗生存率分别为: 81% 、 60% 和 44%,而 LTc + 和 LR + 组分别为 86% 、 58% 和 58% 分别 (p = 0.746)。11 例 LTc + 患者退出。LT 后 OS 分别为 81% 、 68% 和 59% (与 LR + 组无差异; p = 0.844)。LT 后有更好的 DFS,达到 78% 、 68% 和 56%,而 LR + 组为 53% 、 33% 和 33% (p = 0.062)。 结论: 这是 HIV + 患者 HCC 的最大系列切除术和第一意向治疗分析。虽然 LT 和切除并不总是涉及相同的人群,但它们能够获得相当的生存率。以较高的复发率为代价,切除可以整合在肝脏外科医生的全球军械库中。

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影响因子:3.87
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DOI:10.1111/liv.14321
作者列表:["Chen VL","Chen Y","Du X","Handelman SK","Speliotes EK"]

METHODS:BACKGROUND AND AIMS:Cirrhosis is characterized by extensive fibrosis of the liver and is a major cause of liver-related mortality. Cirrhosis is partially heritable but genetic contributions to cirrhosis have not been systemically explored. Here, we carry out association analyses with cirrhosis in two large biobanks and determine the effects of cirrhosis associated variants on multiple human disease/traits. METHODS:We carried out a genome-wide association analysis of cirrhosis as a diagnosis in UK BioBank (UKBB; 1088 cases vs. 407 873 controls) and then tested top-associating loci for replication with cirrhosis in a hospital-based cohort from the Michigan Genomics Initiative (MGI; 875 cases of cirrhosis vs. 30 346 controls). For replicating variants or variants previously associated with cirrhosis that also affected cirrhosis in UKBB or MGI, we determined single nucleotide polymorphism effects on all other diagnoses in UKBB (PheWAS), common metabolic traits/diseases and serum/plasma metabolites. RESULTS:Unbiased genome-wide association study identified variants in/near PNPLA3 and HFE, and candidate variant analysis identified variants in/near TM6SF2, MBOAT7, SERPINA1, HSD17B13, STAT4 and IFNL4 that reproducibly affected cirrhosis. Most affected liver enzyme concentrations and/or aspartate transaminase-to-platelet ratio index. PheWAS, metabolic trait and serum/plasma metabolite association analyses revealed effects of these variants on lipid, inflammatory and other processes including new effects on many human diseases and traits. CONCLUSIONS:We identified eight loci that reproducibly associate with population-based cirrhosis and define their diverse effects on human diseases and traits.

翻译标题与摘要 下载文献
影响因子:2.57
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DOI:10.1111/eci.13198
作者列表:["Li H","Wieser A","Zhang J","Liss I","Markwardt D","Hornung R","Neumann-Cip AC","Mayerle J","Gerbes A","Steib CJ"]

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