Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
PURPOSE: Currently, there are no guidelines for the management of solitary pulmonary nodules (SPN) in hepatocellular carcinoma (HCC) patients being evaluated for liver transplantation (LT). Obtaining a lung biopsy in cirrhotic patients can often be associated with significant risks. At our center, if nodules are reported benign on CT or unchanged in size over a 6 month period, we proceed to transplant listing. The objective of our study is to evaluate the prevalence and clinical significance of pulmonary nodules in HCC patients undergoing LT.
METHODS: Patients with primary diagnosis of HCC who received LT at our institution between 2000 and 2015 were retrospectively evaluated. All patients had MRI-confirmed HCC within Milan Criteria and a concurrent CT chest. SPN characteristics, location, and frequency were studied and co-related with clinical outcomes using Chi-Square and Wilcoxon Rank Sum tests. Survival estimates were calculated with the Kaplan-Meier method.
RESULTS: In this study, 221 patients met the criteria for inclusion. Median follow-up was 46 months. A total of 224 SPN were detected in 111 patients (50.2%); 52 patients (23.5%) had multiple SPN. When stratified by SPN size, 95 patients (85.6%) had SPN < 1cm. On univariate analysis, the presence of SPN did not negatively impact patient survival. In patients who had SPN, the number, laterality, or the presence of calcifications were not associated with decreased survival (p>0.05). However, SPN size >1cm was associated with decreased overall survival (p<0.01) and cause of death primarily due to malignancy (p=0.06; Fig. 1).
CONCLUSION: In HCC patients undergoing pre-transplant evaluation, SPN >1cm is associated with decreased patient survival due death from malignancy. This subgroup should undergo more rigorous evaluation, including a histological assessment of SPN.
CITATION INFORMATION: Serrano O, Bangdiwala A, Vock D, Kirchner V, Yadav K, Pugalendhi A, Minja E, Dunn T, Finger E, Matas A, Kandaswamy R, Payne W, Pruett T, Chinnakotla S. Clinical Significance of Solitary Pulmonary Nodules in Liver Transplant Recipients with Hepatocellular Carcinoma. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Serrano O, Bangdiwala A, Vock D, Kirchner V, Yadav K, Pugalendhi A, Minja E, Dunn T, Finger E, Matas A, Kandaswamy R, Payne W, Pruett T, Chinnakotla S. Clinical Significance of Solitary Pulmonary Nodules in Liver Transplant Recipients with Hepatocellular Carcinoma. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/clinical-significance-of-solitary-pulmonary-nodules-in-liver-transplant-recipients-with-hepatocellular-carcinoma/. Accessed March 5, 2021.
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