Achieving Complete Remission of Hepatocellular Carcinoma: A Significant Predictor for Recurrence-Free Survival after Liver Transplantation

BACKGROUND: Liver transplantation (LT) is a curative treatment for hepatocellular carcinoma (HCC) and the underlying primary liver disease; however, tumor recurrence is still a major issue. Therefore, the aim of this study was to assess predictors and risk factors for HCC recurrence after LT in pati...

Authors: Bürger, Christin
Maschmeier, Miriam
Hüsing-Kabar, Anna
Wilms, Christian
Köhler, Michael
Schmidt, Martina
Schmidt, Hartmut
Kabar, Iyad
Division/Institute:FB 05: Medizinische Fakultät
Document types:Article
Media types:Text
Publication date:2019
Date of publication on miami:15.01.2020
Modification date:23.01.2020
Edition statement:[Electronic ed.]
Source:Canadian Journal of Gastroenterology and Hepatology 2019 (2019), 5796074, 1-7
DDC Subject:610: Medizin und Gesundheit
License:CC BY 4.0
Language:English
Funding:Finanziert durch den Open-Access-Publikationsfonds der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format:PDF document
URN:urn:nbn:de:hbz:6-32159598834
Permalink:http://nbn-resolving.de/urn:nbn:de:hbz:6-32159598834
Other Identifiers:DOI: 10.1155/2019/5796074
Digital documents:artikel_kabar_2019.pdf

BACKGROUND: Liver transplantation (LT) is a curative treatment for hepatocellular carcinoma (HCC) and the underlying primary liver disease; however, tumor recurrence is still a major issue. Therefore, the aim of this study was to assess predictors and risk factors for HCC recurrence after LT in patients within and outside the Milan criteria with a special focus on the impact of different bridging strategies. METHODS: All patients who underwent LT for HCC between 07/2002 and 09/2016 at the University Hospital of Muenster were consecutively included in this retrospective study. Database research was performed and a multivariable regression analysis was conducted to explore potential risk factors for HCC recurrence. RESULTS: A total of 82 patients were eligible for the statistical analysis. Independent of bridging strategy, achieving complete remission (CR) was significantly associated with a lower risk for tumor recurrence (p = 0.029; OR = 0.426, 95% CI 0.198-0.918). A maximal diameter of lesion < 3 cm was also associated with lower recurrence rates (p = 0.040; OR = 0.140, 95% CI 0.022-0.914). Vascular invasion proved to be an independent risk factor for HCC recurrence (p = 0.004; OR = 11.357, 95% CI 2.142-60.199). CONCLUSION: Achieving CR prior to LT results in a significant risk reduction of HCC recurrence after LT independent of the treatment modalities applied.