[A retrospective cohort study regarding the effect of sirolimus-based immunosuppression protocol on the long-term survival of hepatocellular carcinoma patients after liver transplantation]

Zhonghua Wai Ke Za Zhi. 2014 Apr;52(4):245-8.
[Article in Chinese]

Abstract

Objective: To evaluate the influence of sirolimus on the long-term survival of patients after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).

Methods: Clinic data of 165 consecutive patients who underwent OLT for HCC from February 2005 to March 2012 was analyzed retrospectively. Among them, 94 patients were treated with a sirolimus-based immunosuppressive protocol after OLT, while the other 71 patients with a FK506-based protocol. Postoperative survival time, survival, disease-free survival (DFS) and tumor recurrence rates between the two groups were compared.

Results: The 2 groups were comparable in all clinicopathologic parameters. The sirolimus-based group had higher patient survival rates than the control group at 1-year (87% vs. 97%, P = 0.03), 2-year (80% vs. 88%), 3-year (76% vs. 85%) and 5-year (63% vs. 75%). The 1-year, 2-year, 3-year and 5-year recurrence rates were 12% vs. 3%, 17% vs. 9%, 21% vs. 9% (P = 0.04) and 31% vs. 16% (P = 0.03). Early and mid-HCC (I - II stage) of 131 cases (control group 61 cases, sirolimus-based group of 70 patients). The 1-year, 2-year, 3-year and 5-year survival rates were 90% vs. 97% , 80% vs. 90%, 78% vs. 86% and 65% vs. 82% (P = 0.04) and recurrence rates were 10% vs. 3%, 16% vs. 8%, 18% vs. 8% and 29% vs. 11% (P = 0.01).

Conclusion: The sirolimus-based immunosuppressive protocol reduce long-term postoperative recurrence rate and improve the survival rate of patients after OLT for HCC significantly (especially early-mid HCC).

Publication types

  • Comparative Study
  • English Abstract
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carcinoma, Hepatocellular / drug therapy*
  • Carcinoma, Hepatocellular / mortality*
  • Carcinoma, Hepatocellular / surgery
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / surgery
  • Liver Transplantation
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Sirolimus / therapeutic use*
  • Survival Rate
  • Tacrolimus / therapeutic use

Substances

  • Immunosuppressive Agents
  • Sirolimus
  • Tacrolimus