lected HCC are similar to the results in cirrhotic patients Cumulative recurrence after surgical resection for hewithout tumor. (HEPATOLOGY 1997;25:1485-1489.) patocellular carcinoma (HCC) is very high. Several retrospective analyses have shown that liver transplantation was more effective than resection for patients with Hepatocellular carcinoma (HCC) usually occurs with the HCC at early tumor stages. Consequently, in January presence of cirrhosis and is considered to have a poor progno-1990, we decided to prospectively indicate orthotopic sis.1 To the present, surgical resection has been the treatment liver transplantation (OLT) as the first surgical treat-of choice whenever feasible.2 However, the resection rate rement for small, localized HCC in cirrhotic patients with-mains low in cirrhotic patients. 3,4 In the last few years, some out nodal involvement independently of the degree of groups have reported disappointing long-term results after liver function. The aim of this prospective cohort study resection of small tumors in cirrhotic patients. The 5-year was to analyze prognosis, recurrence rate, and survival recurrence rate is very high, 74% among 386 patients acafter liver transplantation in patients in whom the main cording to Makuuchi, 5 and 100% in Belghiti's series. 6 Other indication was HCC with cirrhosis. Thirty-eight patients authors have accepted orthotopic liver transplantation (OLT) in whom the main indication for liver transplantation as a treatment indication in patients with advanced tumors was HCC and hepatic cirrhosis were compared with 136 or with associated end-stage liver disease.7-11 Moreover, sevtransplantations because of cirrhosis without tumor, eral retrospective analyses have recently shown that OLT performed in our unit from January 1990 to December was more effective than liver resection for patients with HCC 1995. HCC arising in noncirrhotic livers and those inci-at early tumor stages. 7,8,10,11 However unfavorable results dently discovered after OLT were excluded from the compared with benign disease and a shortage of donor organs study. Chemoembolization using doxorubicin, lipiodol, have led to a restricted indication of liver transplantation for and Gelfoam was performed before OLT in 31 patients HCC.12-14 On the other hand, the absence of recurrence after with good liver function. There were no differences in transplantation for incidental HCC prompted us to look for gender, but HCC patients were older (57 { 7 vs. 50 { 10 favorable preoperative staging criteria for small HCC in ciryears [P õ .001]). Liver function was better in HCC rhosis with regard to OLT, 15 but there is no general agree-(Child-Pugh score: 6.9 { 2 vs. 8.6 { 1.8; P õ .001), and ment as to the selection of ideal candidates for OLT. [7][8][9][10][11][12]16 hepatitis C virus antibody was positive in 31 (82%) vs. 51The 5-year survival rate after liver resection for HCC is (37%) (P õ .007). Seven tumors had bilobar involvement very poor, ranging from 12% to 50% in both eastern and (18%). Capsule was presen...

To assess the presence of MSI in colorectal cancer, we have developed a simple, sensitive, and specific approach based on the apparent good fit of the data to a two-population model. Its application to a prospective series of patients with colorectal carcinomas demonstrates that the presence of MSI characterizes a subset of less aggressive tumors.

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To assess the biological significance of human chorionic gonadotropin (HCG) detection in large bowel carcinomas, we have studied immunohistochemically 50 colorectal carcinomas, 20 adenomas, 8 ulcerative colitis, and 10 normal colonic mucosae. The HCG-immunoreactive cells were found in 26 carcinomas (52%). Positivity was not detected in any normal mucosa or benign lesions. Cells containing HCG predominated in mucinous (80%) and poorly differentiated carcinomas (92%). No trophoblastic differentiation could be demonstrated in any tumor. Human chorionic gonadotropin was detected more frequently in carcinomas invading the entire bowel wall (67%) than in those confined to the submucosa or muscularis propria (30%). Fifteen of 19 cases (79%) with lymph node and/or hepatic metastases had HCG in the primary tumor, whereas only 9 of 23 cases (32%) without metastases showed HCG immunoreactivity. The eight patients with hepatic metastases had HCG in the primary tumor. Thus, the immunohistochemical detection of HCG in colorectal carcinomas may be a biological marker of prognostic significance.

Treatment results in our study population were better than those observed in the general population. The long-term response achieved, which was maintained after transplantation, supports the use of IFN for HCV hepatitis in kidney transplant candidates under hemodialysis.

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