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Title: Bridging Locoregional Therapy Prolongs Survival in Patients Listed for Liver Transplant with Hepatocellular Carcinoma

Abstract

Background and AimsTo evaluate the long-term survival benefit of bridging locoregional therapy (LRT) prior to orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC) within Milan criteria.MethodsOur transplant center registry was studied for all HCC patients within the Milan criteria who were listed for OLT from 1998 to 2013. Baseline clinical characteristics and median overall survival (OS) were calculated and stratified by LRT, OLT status, and wait times. Survival analysis was conducted using Kaplan–Meier estimation and log-rank test.ResultsOf 265 listed, 205 underwent OLT (mean follow-up 7.6 years). Of 205, 111 received bridging LRT (A), and 94 did not (B). Both were similar in demographics and tumor characteristics (p > 0.05). Median OS from HCC for A/B were 86.4 vs. 68.9 months (p = 0.01). Median OS from OLT for A/B were 74.6 vs. 63.6 months (p = 0.03). On multivariate analysis, independent predictors for survival from HCC were bridging LRT (p = 0.002) and high wait time (p = 0.008); independent predictors for survival from OLT were bridging LRT (p = 0.005) and high wait time (p = 0.005). Of 60 who were listed but did not undergo transplant, 44 received LRT (C) and 16 received best supportive care (D). Median OS from HCC for C/D were 37.1 vs. 24.8 months (p = 0.03).ConclusionsBridging LRT and high waitmore » times were independent positive prognostic factors for survival from HCC diagnosis and OLT.« less

Authors:
 [1];  [2];  [3]; ;  [2];  [4];  [5];  [1]
  1. Yale School of Medicine, Interventional Radiology, Department of Radiology and Biomedical Imaging (United States)
  2. Emory University School of Medicine, Division of Digestive Diseases, Department of Medicine (United States)
  3. Stanford University School of Medicine, Division of Gastroenterology and Hepatology (United States)
  4. Duke University School of Medicine, Division of Transplant Surgery, Department of Surgery (United States)
  5. University of Pittsburgh, Department of Biostatistics, Graduate School of Public Health (United States)
Publication Date:
OSTI Identifier:
22645314
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 3; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DIAGNOSIS; HEPATOMAS; LIVER; MULTIVARIATE ANALYSIS; PATIENTS; THERAPY; TRANSPLANTS; VANADIUM 63; WHO

Citation Formats

Xing, Minzhi, Sakaria, Sonali, Dhanasekaran, Renumathy, Parekh, Samir, Spivey, James, Knechtle, Stuart J., Zhang, Di, and Kim, Hyun S., E-mail: kevin.kim@yale.edu. Bridging Locoregional Therapy Prolongs Survival in Patients Listed for Liver Transplant with Hepatocellular Carcinoma. United States: N. p., 2017. Web. doi:10.1007/S00270-016-1505-0.
Xing, Minzhi, Sakaria, Sonali, Dhanasekaran, Renumathy, Parekh, Samir, Spivey, James, Knechtle, Stuart J., Zhang, Di, & Kim, Hyun S., E-mail: kevin.kim@yale.edu. Bridging Locoregional Therapy Prolongs Survival in Patients Listed for Liver Transplant with Hepatocellular Carcinoma. United States. doi:10.1007/S00270-016-1505-0.
Xing, Minzhi, Sakaria, Sonali, Dhanasekaran, Renumathy, Parekh, Samir, Spivey, James, Knechtle, Stuart J., Zhang, Di, and Kim, Hyun S., E-mail: kevin.kim@yale.edu. Wed . "Bridging Locoregional Therapy Prolongs Survival in Patients Listed for Liver Transplant with Hepatocellular Carcinoma". United States. doi:10.1007/S00270-016-1505-0.
@article{osti_22645314,
title = {Bridging Locoregional Therapy Prolongs Survival in Patients Listed for Liver Transplant with Hepatocellular Carcinoma},
author = {Xing, Minzhi and Sakaria, Sonali and Dhanasekaran, Renumathy and Parekh, Samir and Spivey, James and Knechtle, Stuart J. and Zhang, Di and Kim, Hyun S., E-mail: kevin.kim@yale.edu},
abstractNote = {Background and AimsTo evaluate the long-term survival benefit of bridging locoregional therapy (LRT) prior to orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC) within Milan criteria.MethodsOur transplant center registry was studied for all HCC patients within the Milan criteria who were listed for OLT from 1998 to 2013. Baseline clinical characteristics and median overall survival (OS) were calculated and stratified by LRT, OLT status, and wait times. Survival analysis was conducted using Kaplan–Meier estimation and log-rank test.ResultsOf 265 listed, 205 underwent OLT (mean follow-up 7.6 years). Of 205, 111 received bridging LRT (A), and 94 did not (B). Both were similar in demographics and tumor characteristics (p > 0.05). Median OS from HCC for A/B were 86.4 vs. 68.9 months (p = 0.01). Median OS from OLT for A/B were 74.6 vs. 63.6 months (p = 0.03). On multivariate analysis, independent predictors for survival from HCC were bridging LRT (p = 0.002) and high wait time (p = 0.008); independent predictors for survival from OLT were bridging LRT (p = 0.005) and high wait time (p = 0.005). Of 60 who were listed but did not undergo transplant, 44 received LRT (C) and 16 received best supportive care (D). Median OS from HCC for C/D were 37.1 vs. 24.8 months (p = 0.03).ConclusionsBridging LRT and high wait times were independent positive prognostic factors for survival from HCC diagnosis and OLT.},
doi = {10.1007/S00270-016-1505-0},
journal = {Cardiovascular and Interventional Radiology},
number = 3,
volume = 40,
place = {United States},
year = {Wed Mar 15 00:00:00 EDT 2017},
month = {Wed Mar 15 00:00:00 EDT 2017}
}