Factors predicting survival after post‐transplant hepatocellular carcinoma recurrence. Issue 3 (March 2013)

• Record Type: Journal Article
• Authors: Toso, Christian; Cader, Sonia; Mentha‐Dugerdil, Ariane; Meeberg, Glenda; Majno, Pietro; Morard, Isabelle; Giostra, Emiliano; Berney, Thierry; Morel, Philippe; Mentha, Gilles; Kneteman, Norman M.
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 20:Issue 3(2013)
• Page Start: 342
• Page End: 347
• Publication Date: 2013-03
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1007/s00534-012-0528-4
• Languages: English
• ISSNs: 1868-6974

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jhbp2010-sec-0001" sec-type="section"> <title>Background</title> <p>Although factors associated with an increased risk of recurrence after liver transplantation for hepatocellular carcinoma (HCC) have been extensively studied, the history of patients with a post‐transplant recurrence is poorly known.</p> </sec> <sec id="jhbp2010-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients experiencing a post‐transplant HCC recurrence from 1996 to 2011 in two transplant programs were included. Demographic, transplant, and post‐recurrence variables were assessed.</p> </sec> <sec id="jhbp2010-sec-0003" sec-type="section"> <title>Results</title> <p>Thirty patients experienced an HCC recurrence—22 men and 8 women with a mean age of 55 ± 6 years. Sixteen (53 %) were outside the Milan criteria at the time of transplantation. Most recurrences (60 %) appeared within the first 18 months after transplantation, ranging between 1.7 and 109 months (median 14.2 months). Mean post‐recurrence survival was 33 ± 31 months. On univariate analysis, total tumor volume (TTV;<italic>p</italic> = 0.047), microvascular invasion (<italic>p</italic> = 0.011), and time from transplant to recurrence (<italic>p</italic> = 0.001) predicted post‐recurrence survival. On multivariate analysis, both time from transplant to recurrence (<italic>p</italic> = 0.001) and history of rejection (<italic>p</italic> = 0.043), but not the location of the recurrence or the type of recurrence treatment, predicted post‐recurrence survival.</p> </sec> <sec id="jhbp2010-sec-0004" sec-type="section"> <title>Conclusion</title> <p>This study suggests that patients with early post‐transplant HCC recurrence have worse outcomes. Those with a history of graft rejection have better survivals, possibly due to more active anti‐cancer immunity.</p> </sec> </abstract>