This study was presented in part as a poster presentation at Digestive Disease Week, 7–11 May 2011, Chicago, Illinois.
Loco-regional therapy in patients with Milan Criteria-compliant hepatocellular carcinoma and short waitlist time to transplant: an outcome analysis
Article first published online: 27 MAR 2012
© 2012 International Hepato-Pancreato-Biliary Association
Volume 14, Issue 5, pages 325–332, May 2012
How to Cite
Sourianarayanane, A., El-Gazzaz, G., Sanabria, J. R., Menon, K. V. N., Quintini, C., Hashimoto, K., Kelly, D., Eghtesad, B., Miller, C., Fung, J. and Aucejo, F. (2012), Loco-regional therapy in patients with Milan Criteria-compliant hepatocellular carcinoma and short waitlist time to transplant: an outcome analysis. HPB, 14: 325–332. doi: 10.1111/j.1477-2574.2012.00453.x
- Issue published online: 4 APR 2012
- Article first published online: 27 MAR 2012
- Received 29 November 2011; accepted 13 February 2012
- liver transplantation;
- hepatocellular carcinoma;
- Milan Criteria;
- waiting time;
- loco-regional therapy;
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.