Recurrence of Hepatocellular Carcinoma After Transarterial Chemoembolization (TACE) Alone and TACE in Combination With Other Treatment Modalities
General Surgery, Houston Methodist Hospital, Houston, TX.
Meeting: 2015 American Transplant Congress
Abstract number: D189
Keywords: Hepatocellular carcinoma, Liver transplantation, Recurrence, Survival
Session Information
Session Name: Poster Session D: Liver Transplantation for Hepatocellular Carcinoma
Session Type: Poster Session
Date: Tuesday, May 5, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
AIM:
Treatment of hepatocellular carcinoma (HCC) with transarterial chemoembolization (TACE) can help downstage tumors prior to orthotopic liver transplantation (OLT); however, there is a risk of tumor recurrence. The aim of this study was to examine the incidence of HCC recurrence after TACE versus after TACE and an additional treatment modality in patients who underwent OLT.
METHODS:
This is a single center retrospective review. From 4/2007 to 12/2011, 44/121 patients (36%) who underwent TACE ultimately proceeded to OLT. These 44 were treated prior to transplant in 1 of 5 ways: 1) TACE alone, 2) TACE + radiofrequency ablation (RFA), 3) TACE + chemotherapy, 4) TACE + RFA + chemotherapy, or 5) TACE + Yttrium sphere (Y90) therapy. Tumor recurrence was measured by increasing AFP post-transplant and/or positive surveillance MRI and confirmation with histology on biopsy.
RESULTS:
In the 44 patients who received TACE +/- another modality and proceeded to OLT, the average number of clinical tumor number was 2, , clinical maximum tumor size 2.96 cm and clinical total tumor size of 4.57 cm. Average explant tumors was 2.46 with total tumor size of 5.5cm; average percent necrosis was 63%. Seven (16%) of these patients had HCC recurrence that occurred at a median of 542 days post-transplant. Average number of explant tumors in this subset was 1.43 with a total tumor size of 6.32 cm; average percent necrosis was 51%. Among these 7 patients, 5 (71%) had been treated with TACE alone, and 2 (29%) were treated with TACE + chemotherapy. There were no recurrences in the RFA or Y90 groups. The average number of TACE procedures per patient in those with recurrences was 2.14. The disease-free survival rate at 1-, 3-, and 5-years post-transplant was 71%, 57%, and 57%, respectively.
CONCLUSIONS:
In our single center experience, there was a 15% HCC recurrence rate after treatment with TACE. In these patients, more aggressive treatment with TACE in addition to another modality (RFA or Y90) should be considered prior to transplant.
To cite this abstract in AMA style:
Balogh J, Islam A, Saharia A, Monsour H, Burroughs SGordon, Weiner M, Gaber A, Ghobrial R. Recurrence of Hepatocellular Carcinoma After Transarterial Chemoembolization (TACE) Alone and TACE in Combination With Other Treatment Modalities [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/recurrence-of-hepatocellular-carcinoma-after-transarterial-chemoembolization-tace-alone-and-tace-in-combination-with-other-treatment-modalities/. Accessed December 6, 2023.« Back to 2015 American Transplant Congress