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.
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.
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Authors: Jeremy R Parfitt; Paul Marotta; Mohammed Alghamdi; William Wall; Anand Khakhar; Neville G Suskin; Douglas Quan; Vivian McAllister; Cam Ghent; Mark Levstik; Carolyn McLean; Subrata Chakrabarti; Bertha Garcia; David K Driman Journal: Liver Transpl Date: 2007-04 Impact factor: 5.799
Authors: Francis Y Yao; Ryutaro Hirose; Jeanne M LaBerge; Timothy J Davern; Nathan M Bass; Robert K Kerlan; Raphael Merriman; Sandy Feng; Chris E Freise; Nancy L Ascher; John P Roberts Journal: Liver Transpl Date: 2005-12 Impact factor: 5.799
Authors: Paige M Porrett; Heather Peterman; Mark Rosen; Seema Sonnad; Michael Soulen; James F Markmann; Abraham Shaked; Emma Furth; K Rajender Reddy; Kim Olthoff Journal: Liver Transpl Date: 2006-04 Impact factor: 5.799
Authors: Richard B Freeman; Russell H Wiesner; Erick Edwards; Ann Harper; Robert Merion; Robert Wolfe Journal: Liver Transpl Date: 2004-01 Impact factor: 5.799