E-ISSN: 1305-3612
Does neoadjuvant doxorubicin drug-eluting bead transarterial chemoembolization improve survival in patients undergoing liver transplant for hepatocellular carcinoma?
PDF
Cite
Share
Request
Interventional Radiology - Original Article
VOLUME: 23 ISSUE: 6
P: 441-447
November 2017

Does neoadjuvant doxorubicin drug-eluting bead transarterial chemoembolization improve survival in patients undergoing liver transplant for hepatocellular carcinoma?

Diagn Interv Radiol 2017;23(6):441-447
DOI: 10.5152/dir.2017.17106
Dimitri Dorcaratto 1
Venkatesha Udupa 1
Niamh M. Hogan 1
David P. Brophy 2
Jeffrey W. McCann 2
Donal Maguire 1
Justin Geoghegan 1
Colin P. Cantwell 2
Emir Hoti 1
1. Hepatobiliary and Liver Transplant Surgical Unit, St. Vincent’s University Hospital, Elm Park, Dublin, Ireland
2. Department of Radiology, St. Vincent’s University Hospital, Elm Park, Dublin, Ireland
No information available.
No information available
Received Date: 20.03.2017
Accepted Date: 22.06.2017
PDF
Cite
Share
Request

ABSTRACT

PURPOSE:

We aimed to compare the overall (OS) and disease-free survival (DFS) of patients undergoing orthotopic liver transplant (OLT) for hepatocellular carcinoma who did and did not have neoadjuvant doxorubicin drug-eluting bead transarterial chemoembolization (DEB-TACE).

METHODS:

This is a retrospective study of 94 patients with HCC transplanted between 2000 and 2014 in a single tertiary center. Pre- and postoperative features, DFS and OS were compared between patients who received pre-OLT DEB-TACE (n=34, DEB-TACE group) and those who did not (n=60, non-TACE group). Radiologic and histologic response to neoadjuvant treatment as well as its complications were also studied.

RESULTS:

There were no significant differences in post-transplantation DFS and OS rates between groups (5-year DFS: 70% in DEB-TACE group vs. 63% in non-TACE group, P = 0.454; 5-year OS: 70% in DEB-TACE group vs. 65% in non-TACE group, P = 0.532). The DEB-TACE group had longer OLT waiting time compared with the non-TACE group (110 vs. 72 days; P = 0.01). On univariate and multivariate analyses, alpha-fetoprotein (AFP) levels >500 ng/mL prior to OLT were associated with decreased OS and DFS regardless of neoadjuvant approach (hazard ratio of 6, P = 0.001 and 5.5, P = 0.002, respectively).

CONCLUSION:

Patients who underwent neoadjuvant DEB-TACE and OLT for hepatocellular carcinoma had no statistically different OS or DFS at 3 and 5 years from patients undergoing OLT alone.