Impact of Bridging Locoregional Therapies for Hepatocellular Carcinoma on Post-transplant Clinical Outcome

被引：5

作者：

Adeniji, Nia ^{[1
]}

Arjunan, Vinodhini ^{[2
]}

Prabhakar, Vijay ^{[3
]}

Tulu, Zeynep ^{[4
]}

Kambham, Neeraja ^{[5
]}

Ahmed, Aijaz ^{[2
]}

Kwo, Paul ^{[2
]}

Dhanasekaran, Renumathy ^{[2
]}

机构：

[1] Stanford Univ, Sch Med, 300 Pasteur Dr,Alway Bldg M211, Stanford, CA 94305 USA

[2] Stanford Univ, Div Gastroenterol & Hepatol, Stanford, CA USA

[3] USC, Div Gastrointestinal & Liver Dis, Keck Sch Med, Los Angeles, CA USA

[4] Stanford Hosp & Clin, Stanford, CA USA

[5] Stanford Univ, Dept Pathol, Stanford, CA 94305 USA

来源：

CLINICAL TRANSPLANTATION | 2020年 / 34卷 / 12期

基金：

美国国家卫生研究院;

关键词：

Hepatocellular carcinoma; Liver cancer; Locoregional therapy; Transarterial chemoembolization; Transplant; LIVER-TRANSPLANTATION; RECURRENCE; CHEMOEMBOLIZATION; CRITERIA;

D O I：

10.1111/ctr.14128

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Long waiting times due to ongoing organ shortage have led to increased utilization of locoregional therapies (LRTs) to bridge patients with hepatocellular carcinoma (HCC) to liver transplantation (LT). We performed this study to evaluate the impact of LRTs on post-LT outcomes. We conducted a retrospective study of patients who were transplanted for HCC at Stanford University Hospital between 2008 and 2018 (n = 302). We found that receipt of >= 5 LRTs was an independent and significant predictor of poor overall 5-year survival (58.3% vs. 83.3%; HR 2.26, p = .03), poor recurrence-free 5-year survival (51.9% vs. 80.4%; HR 2.12, p = .03), and was associated with higher rates of recurrence (25.0% vs. 7.4%, p = .001). Moreover, recurrent HCC was more likely to be the cause of death (58.3% vs. 41.7%, p = .04) in patients who received >= 5 LRTs. Also, patients who required >= 5 LRTs showed an overall lower rate of radiological complete response (46.9% vs. 97.8%, p = .001) and were more likely to have more advanced pathological stage tumors in the explant (65.6% vs. 29.6%, p < .001). In conclusion, receipt of >= 5 bridging LRTs prior to LT is associated with worse post-transplant clinical outcomes.

引用

页数：11

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