Liver Transplantation After Transarterial Chemoembolization and Radiotherapy for Hepatocellular Carcinoma with Vascular Invasion
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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.
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.
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.
In the selected HCC patients with major vascular invasion, LDLT after combined TACE and radiotherapy showed acceptable oncologic outcomes.
KeywordsHepatocellular carcinoma Vascular invasion Living donor liver transplantation Radiotherapy Transarterial chemoembolization
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.
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