Premium
Impact of neoadjuvant transarterial chemoembolization on tumor recurrence and patient survival after liver transplantation for hepatocellular carcinoma: a retrospective analysis
Author(s) -
Seehofer Daniel,
Nebrig Maxim,
Denecke Timm,
Kroencke Thomas,
Weichert Wilko,
Stockmann Martin,
Somasundaram Rajan,
Schott Eckart,
Puhl Gero,
Neuhaus Peter
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2012.01609.x
Subject(s) - medicine , hepatocellular carcinoma , liver transplantation , retrospective cohort study , single center , neoadjuvant therapy , transplantation , cohort , gastroenterology , overall survival , surgery , oncology , cancer , breast cancer
Transarterial chemoembolization ( TACE ) has gained wide acceptance as a bridge to liver transplantation ( LT ) in patients with hepatocellular carcinoma ( HCC ). Aim of this analysis was to compare long‐term results with and without neoadjuvant TACE and to identify subgroups, which particularly benefit from TACE . Patients with HCC transplanted at our center were retrospectively analyzed. The following were excluded to increase consistency: incidental‐ HCC , C hild‐ C , living‐related‐ LT , other HCC ‐specific‐treatment. Of 336 patients, 177 were subject of this analysis, 71 received TACE and 106 no HCC therapy. Patients with and without TACE showed similar five‐yr survival (73/67%) and recurrence rates (23/29%). Progression on the waiting list was associated with a higher recurrence rate in the TACE (50 vs.12%) and the non‐ TACE group (40 vs. 22%). HCC recurrence was reduced in patients inside M ilan (0.053) and UCSF (0.037) criteria by neoadjuvant TACE but not outside UCSF (0.99). Also a trend towards an improved survival was seen within these criteria. Our large single center experience suggests that TACE lowers the HCC recurrence rate in patients inside the M ilan and UCSF criteria. Moreover, the response to TACE is a good indicator of low recurrence rates. The effect of TACE might be more pronounced in patients with longer waiting time than in this cohort (mean, 4.6 months).