Living Donor Liver Transplantation Should Be Considered Cautiously in Recurrent Hepatocellular Carcinoma within the Milan Criteria after Curative Liver Resection
1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of, 2Division of HBP Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea, Republic of, 3Department of Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH
Meeting: 2020 American Transplant Congress
Abstract number: 58
Keywords: Hepatocellular carcinoma, Liver transplantation, Living donor, Tumor recurrence
Session Information
Session Name: Liver: Hepatobiliary Surgery and Liver Transplant Potpourri
Session Type: Oral Abstract Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:45pm
Presentation Time: 4:03pm-4:15pm
Location: Virtual
*Purpose: Insufficient data are available about patient survival following different treatments for recurrent hepatocellular carcinoma (HCC) after primary hepatectomy. We retrospectively evaluated the effects of different treatment modalities on long-term survival.
*Methods: Between 2005 and 2011, 515 hepatectomy patients who developed recurrence within the Milan criteria (MC) were grouped by treatment modality into transarterial chemoembolization(TACE), radiofrequency ablation(RFA), percutaneous ethanol injection(PEI), liver re-resection(RR), living donor liver transplantation(LDLT), and combination of TACE and RFA (TACE-RFA) group.
*Results: Disease-free survival and patient survival after first HCC recurrence were compared according to treatment strategies. TACE (n=230, 44.7%), RFA (n=171, 33.2%), PEI (n=35, 6.8%), RR (n=45, 8.7%), salvage LDLT (n=21, 4.1%), and TACE-RFA (n=13, 2.5%) were all used as the first treatment in recurrent HCC within the MC. The disease-free survival curve from 1st HCC recurrence in the PEI group was lower than in the other groups (P=0.003). The RR, salvage LDLT, and TACE-RFA groups showed good long-term prognosis. The patient survival rate at 3 years after 1st HCC recurrence was 45.2% in TACE, 51.7% in RFA, 39.8% in PEI, 38.2% in RR, 81.4% in salvage LDLT, and 80.8% in the TACE-RFA group. Thus, the patient survival curve in the salvage LDLT and TACE-RFA groups was higher than in the other groups (P=0.04).
*Conclusions: Long-term outcomes for patients with recurrent HCC within the MC do not differ with the first treatment strategies, except for PEI. Salvage LDLT does not prevent HCC recurrence, but it increases patient survival compared with the other treatment strategies.
To cite this abstract in AMA style:
Kim J, Yi N, Choi G, Kwon CD, Lee K, Suh K, Joh J. Living Donor Liver Transplantation Should Be Considered Cautiously in Recurrent Hepatocellular Carcinoma within the Milan Criteria after Curative Liver Resection [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/living-donor-liver-transplantation-should-be-considered-cautiously-in-recurrent-hepatocellular-carcinoma-within-the-milan-criteria-after-curative-liver-resection/. Accessed May 16, 2025.« Back to 2020 American Transplant Congress