Background and aim: To present the long-term results of downstaging with trans-arterial chemo-embolization (TACE) for T2 hepatocellular carcinoma (HCC) before liver transplantation (LT). Materials and methods: This was a retrospective analysis of a single-center, prospectively collected database. The current analysis included 112 patients transplanted between January 1996 and December 2010 and undergoing pre-transplant TACE for radiologically diagnosed T2 HCC. Response to TACE was evaluated one month after the procedure and graded according to the modified RECIST (mRECIST) criteria. Patients were classified as complete response (CR) (group A) or as the composite of stable disease, partial response and progression (group B). Endpoints were evaluation of overall (OS) and recurrence free survival (RFS) according to Kaplan-Meier. Results: Group a (#60) and B (#52) patients were similar in terms of demographics and pre-transplant liver function variables. 5-year OS and RFS were 65% and 92.6%, respectively. After censoring for perioperative deaths (#7), both OS and RFS were higher for group a vs. group B (p<0.05). At multivariate analysis, response to TACE and AFP were independent predictors of RFS. Conclusion: CR after TACE is a predictor of RFS for T2-HCC patients undergoing LT.
Pre-Transplant Downstaging for T2 Hepatocellular Carcinoma
De Simone P;Campani D;Bartolozzi C;Filipponi F.
2014-01-01
Abstract
Background and aim: To present the long-term results of downstaging with trans-arterial chemo-embolization (TACE) for T2 hepatocellular carcinoma (HCC) before liver transplantation (LT). Materials and methods: This was a retrospective analysis of a single-center, prospectively collected database. The current analysis included 112 patients transplanted between January 1996 and December 2010 and undergoing pre-transplant TACE for radiologically diagnosed T2 HCC. Response to TACE was evaluated one month after the procedure and graded according to the modified RECIST (mRECIST) criteria. Patients were classified as complete response (CR) (group A) or as the composite of stable disease, partial response and progression (group B). Endpoints were evaluation of overall (OS) and recurrence free survival (RFS) according to Kaplan-Meier. Results: Group a (#60) and B (#52) patients were similar in terms of demographics and pre-transplant liver function variables. 5-year OS and RFS were 65% and 92.6%, respectively. After censoring for perioperative deaths (#7), both OS and RFS were higher for group a vs. group B (p<0.05). At multivariate analysis, response to TACE and AFP were independent predictors of RFS. Conclusion: CR after TACE is a predictor of RFS for T2-HCC patients undergoing LT.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
