Impact of Bridging Locoregional Therapies for Hepatocellular Carcinoma on Post-transplant Clinical Outcome |
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| Authors: | Nia Adeniji Vinodhini Arjunan Vijay Prabhakar Zeynep Tulu Neeraja Kambham Aijaz Ahmed Paul Kwo Renumathy Dhanasekaran |
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| Affiliation: | 1. Stanford University School of Medicine, Stanford, CA, USA;2. Division of Gastroenterology and Hepatology, Stanford University, Stanford, CA, USA;3. Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of USC, Los Angeles, CA, USA;4. Stanford Hospital and Clinics, Stanford, CA, USA;5. Department of Pathology, Stanford University, Stanford, CA, USA |
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| Abstract: | 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. |
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| Keywords: | Hepatocellular carcinoma Liver cancer Locoregional therapy Transarterial chemoembolization Transplant |
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