The “No-touch” technique improves the survival of patients with advanced hepatocellular carcinomas treated by liver transplantation: A single-center prospective randomized controlled trial

Liver transplantation (LT) is the best treatment for patients with hepatocellular carcinoma (HCC). However, the surgical technique needs to be improved. The present study aimed to evaluate the “no-touch” technique in LT. From January 2018 to December 2019, we performed a prospective randomized contr...

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Veröffentlicht in:Hepatobiliary & pancreatic diseases international 2023-06, Vol.22 (3), p.253-262
Hauptverfasser: Lin, Xin, Xiao, Min, Gu, Yang-Jun, Zhu, Heng-Kai, Li, Meng-Xia, Zhuang, Li, Zheng, Shu-Sen, Li, Qi-Yong
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container_issue 3
container_start_page 253
container_title Hepatobiliary & pancreatic diseases international
container_volume 22
creator Lin, Xin
Xiao, Min
Gu, Yang-Jun
Zhu, Heng-Kai
Li, Meng-Xia
Zhuang, Li
Zheng, Shu-Sen
Li, Qi-Yong
description Liver transplantation (LT) is the best treatment for patients with hepatocellular carcinoma (HCC). However, the surgical technique needs to be improved. The present study aimed to evaluate the “no-touch” technique in LT. From January 2018 to December 2019, we performed a prospective randomized controlled trial on HCC patients who underwent LT. The patients were randomized into two groups: a no-touch technique LT group (NT group, n = 38) and a conventional LT technique group (CT group, n = 46). Operative outcomes and survival in the two groups were analyzed. The perioperative parameters were comparable between the two groups (P > 0.05). There was no significant difference between the two groups in disease-free survival (DFS) (P = 0.732) or overall survival (OS) (P = 0.891). Of 36 patients who were beyond the Hangzhou criteria for LT, the DFS of the patients in the NT group was significantly longer than that in the CT group (median 402 vs. 126 days, P = 0.025). In 31 patients who had portal vein tumor thrombosis (PVTT), DFS and OS in the NT group were significantly better than those in the CT group (median DFS 420 vs. 167 days, P = 0.022; 2-year OS rate 93.8% vs. 66.7%, P = 0.043). In 14 patients who had diffuse-type HCCs, DFS and OS were significantly better in the NT group than those in the CT group (median DFS 141 vs. 56 days, P = 0.008; 2-year OS rate 75.0% vs. 33.3%, P = 0.034). Multivariate analysis showed that for patients with PVTT and diffuse-type HCCs, the no-touch technique was an independent favorable factor for OS (PVTT: HR = 0.018, 95% CI: 0.001-0.408, P = 0.012; diffuse-type HCCs: HR = 0.034, 95% CI: 0.002-0.634, P = 0.024). The no-touch technique improved the survival of patients with advanced HCC compared with the conventional technique. The no-touch technique may provide a new and effective LT technique for advanced HCCs.
doi_str_mv 10.1016/j.hbpd.2022.05.002
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However, the surgical technique needs to be improved. The present study aimed to evaluate the “no-touch” technique in LT. From January 2018 to December 2019, we performed a prospective randomized controlled trial on HCC patients who underwent LT. The patients were randomized into two groups: a no-touch technique LT group (NT group, n = 38) and a conventional LT technique group (CT group, n = 46). Operative outcomes and survival in the two groups were analyzed. The perioperative parameters were comparable between the two groups (P &gt; 0.05). There was no significant difference between the two groups in disease-free survival (DFS) (P = 0.732) or overall survival (OS) (P = 0.891). Of 36 patients who were beyond the Hangzhou criteria for LT, the DFS of the patients in the NT group was significantly longer than that in the CT group (median 402 vs. 126 days, P = 0.025). In 31 patients who had portal vein tumor thrombosis (PVTT), DFS and OS in the NT group were significantly better than those in the CT group (median DFS 420 vs. 167 days, P = 0.022; 2-year OS rate 93.8% vs. 66.7%, P = 0.043). In 14 patients who had diffuse-type HCCs, DFS and OS were significantly better in the NT group than those in the CT group (median DFS 141 vs. 56 days, P = 0.008; 2-year OS rate 75.0% vs. 33.3%, P = 0.034). Multivariate analysis showed that for patients with PVTT and diffuse-type HCCs, the no-touch technique was an independent favorable factor for OS (PVTT: HR = 0.018, 95% CI: 0.001-0.408, P = 0.012; diffuse-type HCCs: HR = 0.034, 95% CI: 0.002-0.634, P = 0.024). The no-touch technique improved the survival of patients with advanced HCC compared with the conventional technique. The no-touch technique may provide a new and effective LT technique for advanced HCCs.</description><identifier>ISSN: 1499-3872</identifier><identifier>DOI: 10.1016/j.hbpd.2022.05.002</identifier><identifier>PMID: 35568681</identifier><language>eng</language><publisher>Singapore: Elsevier B.V</publisher><subject>Carcinoma, Hepatocellular - pathology ; Hepatocellular carcinoma ; Humans ; Liver Neoplasms - pathology ; Liver transplantation ; Liver Transplantation - adverse effects ; Liver Transplantation - methods ; No-touch technique ; Portal Vein - pathology ; Prospective Studies ; Retrospective Studies ; Surgical procedure ; Survival ; Treatment Outcome ; Venous Thrombosis - etiology ; Venous Thrombosis - surgery</subject><ispartof>Hepatobiliary &amp; pancreatic diseases international, 2023-06, Vol.22 (3), p.253-262</ispartof><rights>2022</rights><rights>Copyright © 2022. Published by Elsevier B.V.</rights><rights>Copyright © Wanfang Data Co. Ltd. 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However, the surgical technique needs to be improved. The present study aimed to evaluate the “no-touch” technique in LT. From January 2018 to December 2019, we performed a prospective randomized controlled trial on HCC patients who underwent LT. The patients were randomized into two groups: a no-touch technique LT group (NT group, n = 38) and a conventional LT technique group (CT group, n = 46). Operative outcomes and survival in the two groups were analyzed. The perioperative parameters were comparable between the two groups (P &gt; 0.05). There was no significant difference between the two groups in disease-free survival (DFS) (P = 0.732) or overall survival (OS) (P = 0.891). Of 36 patients who were beyond the Hangzhou criteria for LT, the DFS of the patients in the NT group was significantly longer than that in the CT group (median 402 vs. 126 days, P = 0.025). In 31 patients who had portal vein tumor thrombosis (PVTT), DFS and OS in the NT group were significantly better than those in the CT group (median DFS 420 vs. 167 days, P = 0.022; 2-year OS rate 93.8% vs. 66.7%, P = 0.043). In 14 patients who had diffuse-type HCCs, DFS and OS were significantly better in the NT group than those in the CT group (median DFS 141 vs. 56 days, P = 0.008; 2-year OS rate 75.0% vs. 33.3%, P = 0.034). Multivariate analysis showed that for patients with PVTT and diffuse-type HCCs, the no-touch technique was an independent favorable factor for OS (PVTT: HR = 0.018, 95% CI: 0.001-0.408, P = 0.012; diffuse-type HCCs: HR = 0.034, 95% CI: 0.002-0.634, P = 0.024). The no-touch technique improved the survival of patients with advanced HCC compared with the conventional technique. The no-touch technique may provide a new and effective LT technique for advanced HCCs.</description><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver transplantation</subject><subject>Liver Transplantation - adverse effects</subject><subject>Liver Transplantation - methods</subject><subject>No-touch technique</subject><subject>Portal Vein - pathology</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Surgical procedure</subject><subject>Survival</subject><subject>Treatment Outcome</subject><subject>Venous Thrombosis - etiology</subject><subject>Venous Thrombosis - surgery</subject><issn>1499-3872</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9u1DAQxnMA0VJ4AQ7IRySUxY6drBdxqaryR6rgUs6W40w2Xjl2sJ1Uu6c-CLwLz9InYVZbOHKyNfObbzTfVxSvGF0xypp3u9XQTt2qolW1ovWK0upJcc7EZlNyua7Oiucp7bAoZd08K854XTeykey8-H07AHm4__k1lDnMZni4_0UymMHbHzMQO04xLJBIRirNcbGLdiT0ZNLZgs-J3Nk8EN0t2hvoyADYCAacm52OxOhorA-jRoEIOiPR7omzC0QsaJ8mp31GqeDfk0uSrN86KA0KI4Cb0wQmI02Q7cJoDyhggs8xOIffHK12L4qnvXYJXj6-F8X3j9e3V5_Lm2-fvlxd3pSGb6pcMiEZdHpNOeugEw0XYPqeMs3ZhotGasFbDXWj254J3UtR1ZL1Netp1VLRSX5RvD3p3mnfa79VuzBHjxvVdrft9u3hoA7oPqec0gbpNycar0AjU1ajTUdftIcwJ1U1jVhLIaVAtDqhBg9OEXo1RTvquFeMqmO2aqeO2apjtorWCmPEodeP-nM7Qvdv5G-wCHw4AYCeLBaiSgYTw5BsRFNVF-z_9P8ARa2_UA</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Lin, Xin</creator><creator>Xiao, Min</creator><creator>Gu, Yang-Jun</creator><creator>Zhu, Heng-Kai</creator><creator>Li, Meng-Xia</creator><creator>Zhuang, Li</creator><creator>Zheng, Shu-Sen</creator><creator>Li, Qi-Yong</creator><general>Elsevier B.V</general><general>Jinan Microecological Biomedicine Shandong Laboratory,Jinan 250117,China%Zhejiang University School of Medicine,Hangzhou 310000,China%Department of Surgery,Division of Hepatobiliary and Pancreatic Surgery,Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College,#848 Dongxin Road,Hangzhou 310000,China</general><general>Department of Surgery,Division of Hepatobiliary and Pancreatic Surgery,Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College,#848 Dongxin Road,Hangzhou 310000,China</general><general>Zhejiang University School of Medicine,Hangzhou 310000,China</general><general>Jinan Microecological Biomedicine Shandong Laboratory,Jinan 250117,China%Department of Surgery,Division of Hepatobiliary and Pancreatic Surgery,Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College,#848 Dongxin Road,Hangzhou 310000,China</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>2B.</scope><scope>4A8</scope><scope>92I</scope><scope>93N</scope><scope>PSX</scope><scope>TCJ</scope></search><sort><creationdate>20230601</creationdate><title>The “No-touch” technique improves the survival of patients with advanced hepatocellular carcinomas treated by liver transplantation: A single-center prospective randomized controlled trial</title><author>Lin, Xin ; 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pancreatic diseases international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Xin</au><au>Xiao, Min</au><au>Gu, Yang-Jun</au><au>Zhu, Heng-Kai</au><au>Li, Meng-Xia</au><au>Zhuang, Li</au><au>Zheng, Shu-Sen</au><au>Li, Qi-Yong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The “No-touch” technique improves the survival of patients with advanced hepatocellular carcinomas treated by liver transplantation: A single-center prospective randomized controlled trial</atitle><jtitle>Hepatobiliary &amp; pancreatic diseases international</jtitle><addtitle>Hepatobiliary Pancreat Dis Int</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>22</volume><issue>3</issue><spage>253</spage><epage>262</epage><pages>253-262</pages><issn>1499-3872</issn><abstract>Liver transplantation (LT) is the best treatment for patients with hepatocellular carcinoma (HCC). However, the surgical technique needs to be improved. The present study aimed to evaluate the “no-touch” technique in LT. From January 2018 to December 2019, we performed a prospective randomized controlled trial on HCC patients who underwent LT. The patients were randomized into two groups: a no-touch technique LT group (NT group, n = 38) and a conventional LT technique group (CT group, n = 46). Operative outcomes and survival in the two groups were analyzed. The perioperative parameters were comparable between the two groups (P &gt; 0.05). There was no significant difference between the two groups in disease-free survival (DFS) (P = 0.732) or overall survival (OS) (P = 0.891). Of 36 patients who were beyond the Hangzhou criteria for LT, the DFS of the patients in the NT group was significantly longer than that in the CT group (median 402 vs. 126 days, P = 0.025). In 31 patients who had portal vein tumor thrombosis (PVTT), DFS and OS in the NT group were significantly better than those in the CT group (median DFS 420 vs. 167 days, P = 0.022; 2-year OS rate 93.8% vs. 66.7%, P = 0.043). In 14 patients who had diffuse-type HCCs, DFS and OS were significantly better in the NT group than those in the CT group (median DFS 141 vs. 56 days, P = 0.008; 2-year OS rate 75.0% vs. 33.3%, P = 0.034). Multivariate analysis showed that for patients with PVTT and diffuse-type HCCs, the no-touch technique was an independent favorable factor for OS (PVTT: HR = 0.018, 95% CI: 0.001-0.408, P = 0.012; diffuse-type HCCs: HR = 0.034, 95% CI: 0.002-0.634, P = 0.024). The no-touch technique improved the survival of patients with advanced HCC compared with the conventional technique. The no-touch technique may provide a new and effective LT technique for advanced HCCs.</abstract><cop>Singapore</cop><pub>Elsevier B.V</pub><pmid>35568681</pmid><doi>10.1016/j.hbpd.2022.05.002</doi><tpages>10</tpages></addata></record>
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source MEDLINE; EZB-FREE-00999 freely available EZB journals
subjects Carcinoma, Hepatocellular - pathology
Hepatocellular carcinoma
Humans
Liver Neoplasms - pathology
Liver transplantation
Liver Transplantation - adverse effects
Liver Transplantation - methods
No-touch technique
Portal Vein - pathology
Prospective Studies
Retrospective Studies
Surgical procedure
Survival
Treatment Outcome
Venous Thrombosis - etiology
Venous Thrombosis - surgery
title The “No-touch” technique improves the survival of patients with advanced hepatocellular carcinomas treated by liver transplantation: A single-center prospective randomized controlled trial
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