Early Recurrence Of Hepatocellular Carcinoma Following Transplantation: Risk Score From A Multi-institutional Study Of > 3000 Patients

P. Tabrizian¹, M. Holzner², V. Agopian³, R. Busuttil³, G. Sapisochin⁴, N. Mehta⁵, F. Yao⁵, J. Roberts⁶, S. Florman¹, M. E. Schwartz¹, T. Ivanics⁷, J. Emond⁸, B. Samstein⁹, R. Brown, MD, MPH⁹, M. Najjar¹⁰, W. Chapman¹¹, M. Doyle¹¹, K. Halazun⁹

¹Transplant, Mount Sinai Medical Center, New York, NY, ²Surgery, Georgetown University Hospital, Washington DC, MD, ³Transplant, David Geffen School of Medicine at UCLA, Los Angeles, CA, ⁴Transplant, Univeristy of Toronto, Toronto, ON, Canada, ⁵Transplant, UCSF, San Francisco, CA, ⁶Transplantation, UCSF, San Francisco, CA, ⁷Transplant, University of Toronto, Toronto, ON, Canada, ⁸Transplant, Columbia University Medical Center, New York, NY, ⁹Transplant, Weill Cornell Medical Center, New York, NY, ¹⁰Transplant, Columbia Medical Center, New York, NY, ¹¹Transplant, Washington University School of Medicine, St Louis, MO

Meeting: 2020 American Transplant Congress

Abstract number: B-147

Keywords: Hepatocellular carcinoma, Liver transplantation, Recurrence, Risk factors

Session Information

Session Name: Poster Session B: Liver: Hepatocellular Carcinoma and Other Malignancies

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Early recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) carries a poor prognosis. We aimed to develop a risk score for early HCC recurrence using pre-LT variables.

*Methods: Adults undergoing LT for HCC from 2001-2015 from 6 large centers were reviewed. Competing risk regression was used to identify predictors of early HCC recurrence (≤ 1 year).

*Results: Of 3235 patients, 459 developed HCC recurrence (14.2%), including 175 (38%) recurrences within 1 year of LT. Independent pre-LT predictors of early HCC recurrence included initial tumor size > 3 cm, ≥ 3 pre-LT locoregional therapies, pre-LT neutrophil-to-lymphoycte ratio > 5, and alpha-fetoprotein response. The “early recurrence risk score” was created using hazard ratios and resulted in low (0 points), low-medium (2-4 points), medium-high (5-8 points), and high (>8 points) risk groups (Fig 1). The probability of recurrence at 1-year in the low-risk group was 1.8% vs. 44.9% in the high-risk group (P<0.001) (Fig 2). When stratified according to risk score, those at low-risk for early HCC recurrence had a 5-year overall survival of 80% vs. 40% in the high-risk group (P<0.001) (Fig 2).

*Conclusions: The score provides a risk stratification model for early (≤ 1year) recurrence in patients with HCC undergoing LT. It will benefit in the selection criteria and identify candidates with aggressive tumor biology with poor posttransplant cancer outcomes.

To cite this abstract in AMA style:

Tabrizian P, Holzner M, Agopian V, Busuttil R, Sapisochin G, Mehta N, Yao F, Roberts J, Florman S, Schwartz ME, Ivanics T, Emond J, Samstein B, Brown R, Najjar M, Chapman W, Doyle M, Halazun K. Early Recurrence Of Hepatocellular Carcinoma Following Transplantation: Risk Score From A Multi-institutional Study Of > 3000 Patients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/early-recurrence-of-hepatocellular-carcinoma-following-transplantation-risk-score-from-a-multi-institutional-study-of-3000-patients/. Accessed May 10, 2025.

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