Academic Journal
Evaluation of a delayed liver transplantation strategy for patients with HCC receiving bridging therapy: the DELTA-HCC study.
| العنوان: | Evaluation of a delayed liver transplantation strategy for patients with HCC receiving bridging therapy: the DELTA-HCC study. |
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| المؤلفون: | Lamarque, Catherine, Segaux, L., Bachellier, P., Buchard, B., Chermak, F., Conti, F., Decaens, Thomas, Dharancy, Sebastien, Di Martino, V., Dumortier, J., Francoz-Caudron, C., Gugenheim, J., Hardwigsen, J., Muscari, F., Radenne, S., Salamé, E., Uguen, T., Ursic-Bedoya, J., Antoine, C., Deshayes, A., Jacquelinet, C., Natella, P. A., Leroy, V., Cherqui, D., Oubaya, N., Duvoux, C. |
| المساهمون: | Service d'hépato-gastro-entérologie APHP Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital de Hautepierre Strasbourg, CHU Estaing Clermont-Ferrand, CHU Clermont-Ferrand, Hôpital Haut-Lévêque CHU Bordeaux, Centre Hospitalier Universitaire de Bordeaux (CHU Bordeaux), CHU Pitié-Salpêtrière AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Hôpital Claude Huriez Lille, Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Edouard Herriot CHU - HCL, Hospices Civils de Lyon (HCL), Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital l'Archet, Hôpital de la Timone CHU - APHM (TIMONE), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital de la Croix-Rousse CHU - HCL, Hôpital Trousseau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Pontchaillou, Hôpital Saint Eloi CHU Montpellier, Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Agence de la biomédecine Saint-Denis la Plaine, Hôpital Henri Mondor, Hôpital Paul Brousse |
| المصدر: | ISSN: 0168-8278. |
| بيانات النشر: | CCSD Elsevier |
| سنة النشر: | 2024 |
| مصطلحات موضوعية: | delayed strategy, hepatocellular carcinoma, liver resection, liver transplantation, organ allocation, thermal-ablation, [SDV]Life Sciences [q-bio] |
| الوصف: | International audience ; Background & AimsTo maximize utility and prevent premature liver transplantation (LT), a delayed LT strategy (DS) was adopted in France in 2015 in patients listed for any single HCC treated with resection or thermal ablation during the waiting phase. The DS involves postponing LT until recurrence. The purpose of this study was to evaluate the DS to make sure that it did not hamper pre- and post-LT outcomes.MethodsPatients listed for HCC in France between 2015 and 2018 were studied. After data extraction from the national LT database, 2,025 patients were identified and classified according to six groups: single tumor entering DS, single tumor not entering DS, multiple tumors, no curative treatment, untreatable HCC or T1 tumors. Kaplan-Meier estimates of the 18-month risk of dropout for death, too sick to be transplanted or tumor progression before LT, 5-year post-LT HCC recurrence and post-LT survival rates were compared.ResultsMedian waiting-time in the DS group was 910 days. Pre-LT dropout probability was significantly lower in the DS group compared to other groups (13% vs. 19%, p = 0.0043) and significantly higher in the T1 group (25.4%, p = 0.05). Post-LT HCC recurrence rate in the multiple nodules group was significantly higher (19.6%, p = 0.019), while 5-year post-LT survival did not differ among groups and was 74% in the DS group (p = 0.22).ConclusionThe DELTA-HCC study shows that DS does not negatively impact either pre- nor post-LT patient outcomes, and has the potential to allow for redistribution of organs to patients in more urgent need of LT. It can reasonably be proposed and pursued. The unexpectedly high risk of dropout in T1 patients seems related to the MELD-based offering rules underserving this subgroup. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/38521171; PUBMED: 38521171 |
| DOI: | 10.1016/j.jhep.2024.03.019 |
| الاتاحة: | https://hal.univ-lille.fr/hal-04687155 https://hal.univ-lille.fr/hal-04687155v1/document https://hal.univ-lille.fr/hal-04687155v1/file/PIIS0168827824002022.pdf https://doi.org/10.1016/j.jhep.2024.03.019 |
| Rights: | http://creativecommons.org/licenses/by-nc-nd/ ; info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.C2D27F04 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.jhep.2024.03.019 |
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