Impact of transarterial therapy in hepatitis C-related hepatocellular carcinoma on long-term outcomes after liver transplantation.

Abstract

OBJECTIVES: To evaluate the impact of long-term outcomes of transarterial embolization (TAE) therapy in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) on the waiting list for liver transplantation (LT). METHODS: We retrospectively evaluated the post-LT patients with HCV-related HCC who received TAE intervention (n=33) and those who had no treatment (n=47) while on the waiting list to determine long-term outcomes. RESULTS: Over a 10-year period, of the 424 patients transplanted with HCV, 80 patients had HCC with a tumor burden within Milan criteria. For the entire study cohort, the mean duration of post-LT follow-up was 3.5 years; mean time of transplant waiting list was 120 days; and median post-LT survival was 8.9 years. The survival rates at 1, 3, 5, and 10 years were 82%, 70%, 55%, and 35%, respectively. From the study cohort, 33 patients received TAE and 47 patients did not while on the waiting list. The 2 groups were well matched, except, that the intervention patients received post-LT interferon more often and had a shorter time on the waiting list (56.2 d) when compared with the no treatment group (164.6 d, P<0.001). Median survival in the TAE group was 4.8 years and 8.9 years in the no treatment group. The recurrence rate was 15.6% in the treatment group and 6.9% in the no therapy group (P=0.275). CONCLUSIONS: Pre-LT transarterial therapy has no benefit on post-LT survival and tumor recurrence in patients with HCV-related HCC who underwent a mean waiting period of <3 months to transplant.

Authors

Cabrera, Roniel; Dhanasekaran, Renumathy; Caridi, James; Clark, Virgina; Morelli, Giuseppe; Soldevila-Pico, Consuelo; Magglioca, Joseph; Nelson, David; Firpi, Roberto Jose;

Keywords

  • Adult
  • Aged
  • Carcinoma, Hepatocellular/ etiology
  • Carcinoma, Hepatocellular/ mortality
  • Carcinoma, Hepatocellular/ therapy
  • Embolization, Therapeutic
  • Female
  • Hepacivirus/ pathogenicity
  • Hepatitis C/ complications
  • Hepatitis C/ mortality
  • Hepatitis C/ virology
  • Humans
  • Liver Neoplasms/ etiology
  • Liver Neoplasms/ mortality
  • Liver Neoplasms/ therapy
  • Liver Transplantation
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local/ diagnosis
  • Neoplasm Recurrence, Local/ mortality
  • Neoplasm Recurrence, Local/ therapy
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Waiting Lists

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