Transplantation for Hepatocellularcarcinoma Is There a Tumor Size Limit?
Houston Methodist Hospital, Houston, TX
Cairo University Medical School, Cairo, Egypt
University of Arkansas for Medical Sciences, Little Rock, AR.
Meeting: 2016 American Transplant Congress
Abstract number: A184
Keywords: Hepatocellular carcinoma
Session Information
Session Name: Poster Session A: Liver - Hepatocellular Carcinoma and Cholangiocarcinoma Malignancies
Session Type: Poster Session
Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Background:The advent of tumor size based criteria (Milan and UCSF) for transplantation of Hepatocellular carcinomas (HCC) has facilitated access of tumor patients to transplantation. Recent success in transplanting patients with larger tumors (beyond UCSF) necessitates understanding of patient, tumor and biological criteria that determine successful outcome for HCC Transplantation across all size criteria.
Methods: We analyzed 11,928 patients who received OLT from 2002 till 2013 from the UNOS star file. Clinical outcomes were compared by tumor size at transplant; Milan (N=11555), beyond Milan within UCSF (N=291) & beyond both Milan & UCSF (N=82). Statistical analysis was done to determine factors impacting survival.
Results: There were no statistically significant differences in the 1, 3, and 5 year Survival {Fig 1} between the three patient groups (within Milan 91.1%, 74.8%, 60.3%, beyond Milan within UCSF 92.7%, 71.1%, 51.6%, beyond both Milan & UCSF 95.8%, 75.9%, and 58.1%. In multivariate analysis the hazard ratio and 95% CI of factors significantly affecting survival included, AA race (1.56; 1.37-1.78), AFP >3000 (2.41; 1.77-3.28), Hepatitis C infection (1.45; 1.30-1.62) with age, diabetes and largest tumors diameter having a more modest impact. Total tumor burden and time to transplantation were not significant predictors of survival. Multivariate analysis within Milan only patients demonstrated stability of the hazard ratios for race, hepatitis C infection, tumor diameter, age and diabetes.
Conclusions: These data indicate that based on current clinical selection criteria a small number of large tumors can be successfully treated by transplantation, and points to the need to include markers of HCC biologic behavior beyond size and tumor burden to transplant criteria.
CITATION INFORMATION: Daoud A, Teeter L, Ghobrial M, Graviss E, Mogawer S, Sholkamy A, Alshazly M, Monsour H, Gaber A. Transplantation for Hepatocellularcarcinoma Is There a Tumor Size Limit? Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Daoud A, Teeter L, Ghobrial M, Graviss E, Mogawer S, Sholkamy A, Alshazly M, Monsour H, Gaber A. Transplantation for Hepatocellularcarcinoma Is There a Tumor Size Limit? [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/transplantation-for-hepatocellularcarcinoma-is-there-a-tumor-size-limit/. Accessed May 9, 2025.« Back to 2016 American Transplant Congress