Presented in the plenary session of the 54th annual AASLD meeting, Boston, MA, October 2003 (Hepatology 2003;38:157A).
The Impact of Pre-Operative Loco-Regional Therapy on Outcome After Liver Transplantation for Hepatocellular Carcinoma
Article first published online: 21 JAN 2005
American Journal of Transplantation
Volume 5, Issue 4, pages 795–804, April 2005
How to Cite
Yao, F. Y., Kinkhabwala, M., LaBerge, J. M., Bass, N. M., Brown, R., Kerlan, R., Venook, A., Ascher, N. L., Emond, J. C. and Roberts, J. P. (2005), The Impact of Pre-Operative Loco-Regional Therapy on Outcome After Liver Transplantation for Hepatocellular Carcinoma. American Journal of Transplantation, 5: 795–804. doi: 10.1111/j.1600-6143.2005.00750.x
- Issue published online: 21 JAN 2005
- Article first published online: 21 JAN 2005
- Received 30 August 2004; revised 7 October 2004; accepted for publication 1 November 2004
- Hepatocellular carinoma;
- loco-regional therapy;
- orthotopic liver transplantation
No prior studies have shown that pre-operative loco-regional therapy for hepatocellular carcinoma (HCC) improves survival following orthotopic liver transplantation (OLT). We performed subgroup analyses according to pathologic HCC stage among 168 patients who underwent OLT to test the hypothesis that pre-operative loco-regional therapy confers a survival advantage in a subgroup at intermediate risk for HCC recurrence. Patients with pathologic T3 HCC meeting the proposed UCSF expanded criteria (single lesion not exceeding 6.5 cm or two to three lesions none > 4.5 cm with total tumor diameter within 8 cm) had a similar 5-year recurrence-free survival as patients with pathologic T2 HCC (88.5% vs. 93.8%; p = 0.56). In the subgroup with pathologic T2 or T3 HCC, the 5-year recurrence-free survival was 93.8% for the 85 patients who received pre-operative loco-regional therapy, versus 80.6% for the other 41 patients without treatment (p = 0.049). The treatment benefit, according to 5-year recurrence-free survival, appeared greater for pathologic T3 (85.9% vs. 51.4%; p = 0.05) than T2 HCC (96.4% versus 87.1%; p = 0.12). In conclusion, although the lack of a randomized controlled design precludes drawing firm conclusions, our results suggest that pre-operative loco-regional therapy may confer a survival benefit after OLT in the subgroup with pathologic T2 and T3 HCC.