Elsevier

HPB

Volume 14, Issue 5, May 2012, Pages 325-332
HPB

Original Article
Loco-regional therapy in patients with Milan Criteria-compliant hepatocellular carcinoma and short waitlist time to transplant: an outcome analysis

https://doi.org/10.1111/j.1477-2574.2012.00453.xGet rights and content
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Abstract

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.

Keywords

liver transplantation
survival
hepatocellular carcinoma
HCC
outcomes
Milan Criteria
waiting time
loco-regional therapy
mortality

Cited by (0)

This study was presented in part as a poster presentation at Digestive Disease Week, 7–11 May 2011, Chicago, Illinois.