Recurrent HCC After Radiofrequency Ablation or Liver Resection Can Be Effectively Treated with Salvage Transplantation.

H. Muaddi,¹ D. Al-Adra,¹ J. Shaw,¹ D. Grant,¹ P. Greig,¹ I. McGilvray,¹ M. Cattral,¹ A. Wei,¹ C.-A. Moulton,¹ J. Kachura,² R. Beecroft,² M. Selzner,¹ A. Ghanekar,¹ S. Gallinger,¹ S. Cleary,¹ G. Sapisochin.¹

¹General Surgery, University of Toronto, Toronto, ON, Canada
²Medical Imaging, University of Toronto, Toronto, ON, Canada

Meeting: 2017 American Transplant Congress

Abstract number: A73

Keywords: Hepatocellular carcinoma, Liver transplantation, Tumor recurrence

Session Information

Session Name: Poster Session A: Clinical Science: Liver - Hepatocellular Carcinoma and Cholangiocarcinoma Malignancies

Session Type: Poster Session

Date: Saturday, April 29, 2017

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall D1

Background:

Liver resection (LR) and radiofrequency ablation (RFA) represent curative therapies for early stages of hepatocellular carcinoma (HCC). If tumour recurrence occurs, salvage liver transplant (SLT) may constitute a treatment option. We aimed to compare the long-term outcomes of patients that were transplanted for recurrent HCC after curative-intent therapies (LR or RFA) to those transplanted as initial therapy.

Methods:

We conducted a matched-control (1:1) cohort study comparing patients with HCC treated with primary liver transplant (PLT) to SLT after recurrence following curative-intent treatment with LR or RFA. Matching was performed according to the size and number of viable tumours at explant pathology following liver transplant. Patients that received LR or RFA as a “bridge to transplant” were not included.

Results:

Between Nov 1999-Dec 2014, 559 patients with HCC were transplanted at our Institution. 193 patients were treated with PLT and 50 patients were treated with SLT for HCC recurrence after primary treatment with LR (n=25) or RFA (n=25). Median length of follow-up from transplant was 66 (0.5-195) months. The median time from curative-intent treatment of HCC with RFA or LR to recurrence was 11 (1-36) and 20 (3-143) months, respectively (p=0.09). The matched-cohort was composed of 49 SLT patients (24 LR and 25 RFA) and 49 PLT patients. The median time to recurrence after LR or RFA in the SLT group was 13 (1-143) months. No significant differences were observed in demographic or tumor characteristics between the PLT and SLT groups, except for the median MELD at time of transplant [PLT 13 (6-29) vs. SLT 8 (6-19), p<0.005]. The 5-year cumulative risk of recurrence after LT was 21% in the PLT vs. 33% in the SLT group, p=0.28). The 5-year actuarial survival after PLT was 69% vs. 68% in the SLT group, p=0.68).

Conclusion:

SLT is an acceptable treatment for recurrent HCC following curative-intent therapies with comparable long-term recurrence rates and patient survival.

CITATION INFORMATION: Muaddi H, Al-Adra D, Shaw J, Grant D, Greig P, McGilvray I, Cattral M, Wei A, Moulton C.-A, Kachura J, Beecroft R, Selzner M, Ghanekar A, Gallinger S, Cleary S, Sapisochin G. Recurrent HCC After Radiofrequency Ablation or Liver Resection Can Be Effectively Treated with Salvage Transplantation. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Muaddi H, Al-Adra D, Shaw J, Grant D, Greig P, McGilvray I, Cattral M, Wei A, Moulton C-A, Kachura J, Beecroft R, Selzner M, Ghanekar A, Gallinger S, Cleary S, Sapisochin G. Recurrent HCC After Radiofrequency Ablation or Liver Resection Can Be Effectively Treated with Salvage Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/recurrent-hcc-after-radiofrequency-ablation-or-liver-resection-can-be-effectively-treated-with-salvage-transplantation/. Accessed November 22, 2024.

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