ATC Abstracts

American Transplant Congress abstracts

Predictors of Time to Recurrence and Mortality Associated With Recurrent Hepatocellular Carcinoma After Liver Transplantation

Transplantation, UCLA, Los Angeles, CA.

Meeting: 2015 American Transplant Congress

Abstract number: 315

Keywords: , , ,

Session Information

Session Name: Concurrent Session: Liver Transplantation for Hepatocellular Carcinoma

Session Type: Concurrent Session

Date: Monday, May 4, 2015

Session Time: 4:00pm-5:30pm

 Presentation Time: 4:48pm-5:00pm

Location: Room 113-BC

Background: While recurrent hepatocellular carcinoma (HCC) after liver transplantation (LT) portends a poor prognosis, adjuvant therapy may prolong survival. We sought to identify factors that impact time to recurrence and mortality after recurrence, thus stratifying patients to guide treatment.

Methods: Retrospective analysis of 856 recipients undergoing LT for HCC from 1984 to 2014 identified 106 patients with recurrent tumor. A multivariate Cox regression identified factors affecting time to recurrence and mortality.

Results: Of 106 patients with recurrence, the median time to recurrence and survival after recurrence were 15.8 months (IQR 6.8-33.1) and 10.3 months (IQR 3.8-20.2), respectively (Figure 1), with 19 patients alive (median survival 27.5 months, five 5-year survivors).Multivariate predictors of time to recurrence and mortality are listed in Table 1 and Table 2, respectively.

Multivariable Predictors of Time to Recurrence
Predictor Decrease in time to recurrence(median,months) 95% Confidence Interval P-value
Tumor grade 3-4 vs 1 22.56 15.48-29.65 <0.001
Tumor grade 2 vs 1 13.32 6.55-20.09 <0.001
Maximum Pre-LT AFP (per log SD increase) 4.64 2.71-6.58 <0.001
Maximum tumor diameter (per log SD increase) 1.74 0.15-3.63 0.072
Multivariable Predictors of Mortality after HCC recurrence
Predictor Hazard Ratio 95% Confidence Interval P-value
Post-Recurrence Therapy      
No treatment (vs surgery) 10.32 2.2-49.0 0.003
Chemo/XRT/none (vs surgery) 4.86 1.1-21.7 0.038
Tumor grade 4 2.49 1.0-6.1 0.045
MELD > 23 2.41 1.3-4.5 0.005
Neutrophil-to-Lymphocyte Ratio > 17 2.40 1.1-5.1 0.022
Time to recurrence < 7 months 2.12 1.2-3.8 0.010
No. of recurrent nodules > 3 1.90 1.1-3.2 0.017
Bone/Brain reccurence 1.63 0.98-2.7 0.059
Max diameter of largest recurrence(per log SD increase) 1.51 1.2-1.9 0.001
Conclusion: In the largest single-center analysis of recipients with recurrent HCC, we identify important prognostic factors associated with time to recurrence and mortality that can guide adjuvant therapy. Surgical resection of limited disease can significantly improve survival and should be considered.

To cite this abstract in AMA style:

Bodzin A, Reino D, Lunsford K, Harlander-Locke M, Markovich D, Zarrinpar A, Kaldas F, Farmer D, Busuttil R, Agopian V. Predictors of Time to Recurrence and Mortality Associated With Recurrent Hepatocellular Carcinoma After Liver Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/predictors-of-time-to-recurrence-and-mortality-associated-with-recurrent-hepatocellular-carcinoma-after-liver-transplantation/. Accessed November 21, 2024.

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