Faculty Collaboration Database

Loco-regional therapy in patients with Milan Criteria-compliant hepatocellular carcinoma and short waitlist time to transplant: an outcome analysis. HPB (Oxford) 2012 May;14(5):325-32

Date

04/11/2012

Pubmed ID

22487070

Pubmed Central ID

PMC3384852

DOI

10.1111/j.1477-2574.2012.00453.x

Scopus ID

2-s2.0-84859725883 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

OBJECTIVES: Liver transplantation (LT) in Milan Criteria (MC) hepatocellular carcinoma (HCC) has excellent outcomes. Pre-transplant loco-regional therapy (LRT) has been used to downstage HCC to meet the MC. However, its benefit in patients with a brief waiting time to transplant remains unclear. This study evaluated outcomes in patients with short waitlist times to LT for MC-compliant HCC.

METHODS: Patients undergoing LT for MC HCC at either of two transplant centres between 2002 and 2009 were retrospectively evaluated for outcome. Patients for whom post-transplant follow-up amounted to <12 months were excluded.

RESULTS: A total of 225 patients were included, 93 (41.3%) of whom received neoadjuvant LRT. The median waiting time to transplant was 48 days. Mean post-transplant follow-up was 32.2 months. Overall and disease-free survival at 1 year, 3 years and 5 years were 93.1%, 82.4% and 72.6%, and 91.3%, 79.3% and 70.6%, respectively. There was no difference in overall (P= 0.94) and disease-free survival (P= 0.94) between groups who received and did not receive pre-LT LRT. There were also no disparities in survival or tumour recurrence among categories of patients (with single tumours measuring <3 cm, with single tumours measuring 3-5 cm, with multiple tumours).

CONCLUSIONS: Loco-regional therapy followed by rapid transplantation in MC HCC appears not to have an impact on post-transplant outcome.

Author List

Sourianarayanane A, El-Gazzaz G, Sanabria JR, Menon KV, Quintini C, Hashimoto K, Kelly D, Eghtesad B, Miller C, Fung J, Aucejo F

Author

Achuthan Sourianarayanane MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Analysis of Variance
Carcinoma, Hepatocellular
Chemotherapy, Adjuvant
Chi-Square Distribution
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Liver Neoplasms
Liver Transplantation
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Recurrence, Local
Neoplasm Staging
Ohio
Radiotherapy, Adjuvant
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Waiting Lists