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.
|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|
|Predictor||Hazard Ratio||95% Confidence Interval||P-value|
|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|
|Max diameter of largest recurrence(per log SD increase)||1.51||1.2-1.9||0.001|
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 August 6, 2020.
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