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Journal of Gastrointestinal Surgery

, Volume 21, Issue 2, pp 275–283 | Cite as

Liver Transplantation After Transarterial Chemoembolization and Radiotherapy for Hepatocellular Carcinoma with Vascular Invasion

  • Yuri Jeong
  • Min-Ho Shin
  • Sang Min YoonEmail author
  • Gi-Won SongEmail author
  • Ki-Hun Kim
  • Chul-Soo Ahn
  • Deok-Bog Moon
  • Shin Hwang
  • Jin-hong Park
  • Jong Hoon Kim
  • Sung-Gyu Lee
Original Article

Abstract

Purpose

The study aims to analyze the oncologic outcomes of living donor liver transplantation (LDLT) after combined transarterial chemoembolization (TACE) and radiotherapy for hepatocellular carcinoma (HCC) with major vascular invasion.

Methods

We retrospectively reviewed 17 HCC patients with major vascular invasion who underwent LDLT after combined treatment modality between May 2007 and September 2014. The LDLT timing was determined by the surgeons depending on the disease status and liver function. The intrahepatic recurrence-free survival, disease-free survival (DFS), and overall survival (OS) rates were estimated from the date of the LDLT.

Results

The median follow-up period was 24.5 months (range, 6.4–66.0 months) after the LDLT. The interval between the combined treatment and the LDLT was a median of 5 months (range, 0.4–65.3 months). On the explanted liver, total necrosis was shown in five patients (29.4 %). The 1- and 3-year DFS rates were 70.6 and 57.8 %, respectively. The 1- and 3-year OS rates were 87.4 and 60.5 %, respectively. The major pattern of failure was distant metastasis (35.3 %), and intrahepatic recurrence occurred in three patients (17.6 %) who experienced distant metastasis.

Conclusions

In the selected HCC patients with major vascular invasion, LDLT after combined TACE and radiotherapy showed acceptable oncologic outcomes.

Keywords

Hepatocellular carcinoma Vascular invasion Living donor liver transplantation Radiotherapy Transarterial chemoembolization 

Notes

Authors’ Contributions

Conceived and designed the experiments: YJ MHS SMY GWS KHK CSA DBM SH JHP JHK SGL. Performed the experiments: YJ MHS SMY GWS. Analyzed the data: YJ MHS SMY GWS. Contributed reagents/materials/analysis tools: YJ MHS SMY GWS KHK CSA DBM SH JHP JHK SGL. Wrote the paper: YJ MHS SMY GWS JHK SGL

Compliance with Ethical Standards

Every case of transplantation was evaluated and approved by the local authorities as well as the Korean Network for Organ Sharing affiliated by the Ministry of Health and Welfare of Korea. This study was approved by the Institutional Review Board of Asan Medical Center, and written informed consent was waived due to the retrospective nature of the study. However, all information was treated as anonymous and securely protected so as to prevent any invasion of privacy.

Conflict of Interest

The authors declare that they have no conflict of interest.

Financial Support

None.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2016

Authors and Affiliations

  1. 1.Department of Radiation Oncology, Asan Liver Center, Asan Medical CenterUniversity of Ulsan College of MedicineSongpa-guRepublic of Korea
  2. 2.Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Liver Center, Asan Medical CenterUniversity of Ulsan College of MedicineSongpa-guRepublic of Korea

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