Clinical Impact of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Living Donor Liver Transplantation for Advanced Hepatocellular Carcinoma. Issue 10 (October 2015)

• Record Type: Journal Article
• Authors: Lee, Seung Duk; Kim, Seong Hoon; Kim, Seok-Ki; Kim, Young-Kyu; Park, Sang-Jae
• Is Part Of: Transplantation. Volume 99:Issue 10(2015)
• Publication Date: 2015-10
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000000719
• Languages: English
• ISSNs: 0041-1337

Abstract

Abstract : Background: The relevant number of patients with hepatocellular carcinoma (HCC) beyond the Milan criteria have undergone living donor liver transplantation (LDLT). However, the prognostic factors for these patients with advanced HCC remain unclear. Methods: From March 2005 to May 2013, 280 patients with HCC underwent LDLT at the National Cancer Center. Of these, patients with HCC beyond the Milan criteria were retrospectively enrolled. We analyzed the prognostic significance of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) for selecting appropriate candidates. Results: Of the total 280 patients, 147 (52.5%) were confirmed to have HCC beyond the Milan criteria on the basis of pathological reports. The patients who met and exceeded the Milan criteria had 5-year overall survival (OS) rates of 87.2% and 64.6%, respectively ( P < 0.001). Multivariable analysis for OS and disease-free survival (DFS) in patients with HCC beyond the Milan criteria revealed PET/CT positivity (hazards ratio [HR], 2.714; P = 0.013 for OS; HR, 3.803; P < 0.001 for DFS), total tumor size over 10 cm (HR, 2.333; P = 0.035 for OS; HR, 3.334, P = 0.001 for DFS), and microvascular invasion (HR, 2.917; P = 0.025 for DFS) to be significant prognostic factors. In particular, patients with HCC beyond the Milan criteria with a PET/CT-negative status and total tumor size less than 10 cm showed similar OS and DFS in comparison with those with HCC within the Milan criteria. Conclusions: A PET/CT status in LDLT is a useful marker for predicting survival of patients with advanced HCC. Abstract : Living donor liver transplant recipients with hepatocellular carcinoma (HCC) beyond the Milan criteria with an 18F-FDG-PET/CT-negative and total tumor size <10 cm show similar overall survival and disease-free survival in comparison with those with HCC within the Milan criteria. Supplemental digital content is available in the text.