Introduction: This study aimed to investigate whether everolimus (EVR) affects long-term survival after liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). Materials and Methods: The data from 303 consecutive patients with HCC who had undergone LT from January 2012 to July 2018 were retrospectively reviewed. The patients were divided into two groups: 1) patients treated with EVR in combination with calcineurin inhibitors (CNIs) (EVR group; n=114) and 2) patients treated with CNI-based therapy without EVR (Non-EVR group; n=189). Time to recurrence (TTR) and overall survival (OS) after propensity score (PS) matching were compared between the groups, and prognostic factors for TTR and OS were evaluated. Results: The EVR group exhibited more aggressive tumor biology than the Non-EVR group, such as a higher number of tumors (P = 0.003), a higher prevalence of microscopic vascular invasion (P = 0.017) and exceeding Milan criteria (P = 0.029). Compared with the PS-matched Non-EVR group, the PS-matched EVR group had significantly better TTR (P < 0.001) and OS (P < 0.001). In multivariate analysis, EVR was identified as an independent prognostic factor for TTR (hazard ratio [HR]=0.248; P = 0.001) and OS (HR=0.145; P < 0.001). Conclusion: Combined with CNIs, EVR has the potential to prolong long-term survival in patients undergoing LT for HCC. These findings warrant further investigation in a well-designed prospective study.
Introduction: This study aimed to investigate whether everolimus (EVR) affects long-term survival after liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). Materials and Methods: The data from 303 consecutive patients with HCC who had undergone LT from January 2012 to July 2018 were retrospectively reviewed. The patients were divided into two groups: 1) patients treated with EVR in combination with calcineurin inhibitors (CNIs) (EVR group; n=114) and 2) patients treated with CNI-based therapy without EVR (Non-EVR group; n=189). Time to recurrence (TTR) and overall survival (OS) after propensity score (PS) matching were compared between the groups, and prognostic factors for TTR and OS were evaluated. Results: The EVR group exhibited more aggressive tumor biology than the Non-EVR group, such as a higher number of tumors (P = 0.003), a higher prevalence of microscopic vascular invasion (P = 0.017) and exceeding Milan criteria (P = 0.029). Compared with the PS-matched Non-EVR group, the PS-matched EVR group had significantly better TTR (P < 0.001) and OS (P < 0.001). In multivariate analysis, EVR was identified as an independent prognostic factor for TTR (hazard ratio [HR]=0.248; P = 0.001) and OS (HR=0.145; P < 0.001). Conclusion: Combined with CNIs, EVR has the potential to prolong long-term survival in patients undergoing LT for HCC. These findings warrant further investigation in a well-designed prospective study.
Authors: Deok Gie Kim; Sung Hwa Kim; Shin Hwang; Suk Kyun Hong; Je Ho Ryu; Bong-Wan Kim; Young Kyoung You; Donglak Choi; Dong-Sik Kim; Yang Won Nah; Jai Young Cho; Tae-Seok Kim; Geun Hong; Dong Jin Joo; Myoung Soo Kim; Jong Man Kim; Jae Geun Lee Journal: J Clin Med Date: 2022-05-17 Impact factor: 4.964