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Master Thesis

Traitement des carcinomes hépatocellulaires éligibles à une transplantation et à une résection : résultats carcinologiques et complications des deux stratégies : à propos d'une série rétrospective de 187 cas opérés

Abstract : The best treatment for early hepatocellular carcinoma (HCC) developed in patients with moderate cirrhosis still remains unknown. Only few studies have compared patients eligible to the two therapeutics namely liver resection (LR) or orthotopic liver transplantation (OLT). The aim of this work was to retrospectively analyse overall and disease free survivals of these patients. From 1998 to 2010, our institution has proposed surgical treatments of HCC to 187 patients. Among them, 97 were considered resecable and transplantable (lesions within "up to seven", age under 70 years old and Child A or B cirrhosis). Fifty resections and 47 transplantations were performed. The 1, 3 and 5 years overall survivals were 89, 73 and 40% after a resection versus 80, 76 and 67% after a transplantation (p=0,08). The recurrence rate was 78% in the LR group and 19% in the OLT group (p<0,001). The 1, 3 and 5 years disease free survivals were significantly worse in the case of resection (89, 73 and 30% Vs 90, 88 and 76% after transplantation, p<0,001). ln a multivariate analysis, the recurrence predictive factors were the procedure nature (p=0,009, OR=51, IC95=2-1023) and the presence of "satellite nodules" (p=0,031, OR=10, IC95 = 1,2-87,4). We did not observe any postoperative mortality differences. This study confirms the improved carcinologic results after transplantation compared to those of resection. If there was no shortage of available grafts, a transplantation should be more often proposed as the first choice of treatment for HCC. This work will be used in a study of the intra and peritumoral inflammation markers.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00942871
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Submitted on : Thursday, February 6, 2014 - 4:12:04 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM

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  • HAL Id : dumas-00942871, version 1

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Pierre-Alexandre Waroquet. Traitement des carcinomes hépatocellulaires éligibles à une transplantation et à une résection : résultats carcinologiques et complications des deux stratégies : à propos d'une série rétrospective de 187 cas opérés. Médecine humaine et pathologie. 2013. ⟨dumas-00942871⟩

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