Hala Muaddi1, David P Al-Adra1,2, Rob Beecroft3, Anand Ghanekar1,2, Carol-Anne Moulton1, Adam Doyle2, Markus Selzner1,2, Alice Wei1, Ian D McGilvray1,2, Steven Gallinger1, David R Grant1,2, Mark S Cattral1,2, Paul D Greig1,2, John Kachura3, Sean P Cleary1, Gonzalo Sapisochin4,5. 1. Department of Surgery, University Health Network-Toronto General Hospital, University of Toronto, Toronto, ON, Canada. 2. Department of Surgery, Multi-Organ Transplant. University Health Network-Toronto General Hospital, University of Toronto, Toronto, ON, Canada. 3. Department of Radiology, University Health Network-Toronto General Hospital, University of Toronto, Toronto, ON, Canada. 4. Department of Surgery, University Health Network-Toronto General Hospital, University of Toronto, Toronto, ON, Canada. gonzalo.sapisochin@uhn.ca. 5. Department of Surgery, Multi-Organ Transplant. University Health Network-Toronto General Hospital, University of Toronto, Toronto, ON, Canada. gonzalo.sapisochin@uhn.ca.
Abstract
BACKGROUND: Liver resection (LR) and radiofrequency ablation (RFA) are curative-intent therapies for early stages of hepatocellular carcinoma (HCC). If HCC recurs, salvage liver transplant (SLT) may constitute a treatment option. OBJECTIVE: We aimed to compare the outcomes of patients transplanted for recurrent HCC after curative-intent therapies with those transplanted as initial therapy. METHODS: We conducted a matched-control (1:1) cohort study comparing patients with HCC treated with primary liver transplant (PLT) with SLT after HCC recurrence. Matching was performed according to the size and number of viable tumors at explant pathology following liver transplant. RESULTS: Between November 1999 and December 2014, 687 patients with HCC were listed for transplant at our institution. A total of 559 patients were transplanted; 509 patients were treated with PLT and 50 patients were treated with SLT for HCC recurrence after primary treatment with LR (n = 25) or RFA (n = 25). The median length of follow-up from transplant was 64 months (0.5-195), and the median time from curative-intent treatment of HCC with RFA or LR to recurrence was 9.5 months (1-36) and 14.5 months (3-143), respectively (p = 0.04). The matched cohort was composed of 48 SLT patients (23 LR and 25 RFA) and 48 PLT patients. The 5-year risk of recurrence after LT was 22% in the PLT group versus 32% in the SLT group (p = 0.53), while the 5-year actuarial patient survival after PLT was 69% versus 70% in the SLT group (p = 1). CONCLUSION: Liver transplant is an effective treatment for patients with HCC recurrence following RFA or LR. Outcomes are similar in both groups.
BACKGROUND: Liver resection (LR) and radiofrequency ablation (RFA) are curative-intent therapies for early stages of hepatocellular carcinoma (HCC). If HCC recurs, salvage liver transplant (SLT) may constitute a treatment option. OBJECTIVE: We aimed to compare the outcomes of patients transplanted for recurrent HCC after curative-intent therapies with those transplanted as initial therapy. METHODS: We conducted a matched-control (1:1) cohort study comparing patients with HCC treated with primary liver transplant (PLT) with SLT after HCC recurrence. Matching was performed according to the size and number of viable tumors at explant pathology following liver transplant. RESULTS: Between November 1999 and December 2014, 687 patients with HCC were listed for transplant at our institution. A total of 559 patients were transplanted; 509 patients were treated with PLT and 50 patients were treated with SLT for HCC recurrence after primary treatment with LR (n = 25) or RFA (n = 25). The median length of follow-up from transplant was 64 months (0.5-195), and the median time from curative-intent treatment of HCC with RFA or LR to recurrence was 9.5 months (1-36) and 14.5 months (3-143), respectively (p = 0.04). The matched cohort was composed of 48 SLT patients (23 LR and 25 RFA) and 48 PLT patients. The 5-year risk of recurrence after LT was 22% in the PLT group versus 32% in the SLT group (p = 0.53), while the 5-year actuarial patient survival after PLT was 69% versus 70% in the SLT group (p = 1). CONCLUSION: Liver transplant is an effective treatment for patients with HCC recurrence following RFA or LR. Outcomes are similar in both groups.
Authors: Xue-Liang Zuo; Zhi-Qiang Chen; Jun-Feng Wang; Jin-Guo Wang; Lin-Hu Liang; Juan Cai Journal: Am J Cancer Res Date: 2018-04-01 Impact factor: 6.166
Authors: S Bennett; K Søreide; S Gholami; P Pessaux; C Teh; E Segelov; H Kennecke; H Prenen; S Myrehaug; D Callegaro; J Hallet Journal: Curr Oncol Date: 2020-10-01 Impact factor: 3.677