Response to transarterial chemoembolization may serve as selection criteria for hepatocellular carcinoma liver transplantation.

Abstract

AIMS:

This study sought to extend the inclusion criteria for hepatocellular carcinoma (HCC) liver transplantation (LT), particularly addressing the safety and effectiveness of pre-LT transarterial chemoembolization (TACE).

MATERIALS AND METHODS:

Our study included 115 patients with HCC who underwent LT after TACE. The response measured after each TACE session was based on the mRECIST criteria: complete response (CR), partial response (PR), stable disease (SD) or progressive disease (PD). We defined CR and PR patients as responders (64 cases) and SD and PD patients as non-responders (51 cases).

RESULTS:

The majority of responders could be identified after the first or second TACE sessions (57 cases, 89.1%). Overall survival rates at 1, 3 and 5 years were 95.3%, 89.1% and 75.0%, respectively, in the responder group, and these rates were much higher than those in the non-responder group (86.3%, 66.7% and 54.9%, P=0.016). In addition, the tumor-free survival rate in the responder group was also higher than in the non-responder group (P=0.009). In the responder group, a statistically improved long-term outcome was observed in patients whose HCC did not satisfy the Milan criteria (P<0.05). Univariate and multivariate Cox analyses showed that achieving CR or PR was the best predictor of survival and tumor-free survival following TACE.

CONCLUSION:

The response to TACE, particularly following the first two sessions, primarily and robustly predicted overall and tumor-free survival in HCC patients, particularly those whose HCC did not satisfy the Milan criteria.

• Authors: Jianyong Lei, Jinjing Zhong, Yefang Luo, Lunan Yan, Jinqiang Zhu, Wentao Wang, Bo Li, Tianfu Wen, Jiaying Yang, Liver Surgery Group
• Journal: Oncotarget (Oncotarget) Vol. 8 Issue 53 Pg. 91328-91342 (Oct 31 2017) ISSN: 1949-2553 [Electronic] United States
• PMID: 29207647 (Publication Type: Journal Article)