Results of Liver Transplantation for Hepatocellular Carcinoma in a Multicenter Latin American Cohort Study

ABSTRACT: Background and aims. Background and aims. Heter Background and aims. ogeneous data has been reported regarding liver transplantation (LT) for hepatocellular carcinoma (HCC) in Latin America. We aimed to describe treatment during waiting list, survival and recurrence of HCC after LT in a mu...

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Autores:
Piñero Fernández, Federico
Boteon, Yuri Longatto
Hoyos Duque, Sergio Iván
Marciano, Sebastián
Anders, María Margarita
Varón Puerta, Adriana
Zerega, Alina Raquel
Poniachik Teller, Jaime Melchor
Soza Ried, Alejandro
Padilla Machaca, Martín
Menéndez, Josemaría
Zapata Larraín, Rodrigo
Vilatoba Chapa, Mario
Muñoz Espinosa, Linda Elsa
Maraschio, Martín Alejandro
Fauda, Martín
McCormack, Lucas
Gadano, Adrián Carlos
Boin, Ilka de Fatima
Parente García, José Huygens
Silva, Marcelo Oscar
Costa, Paulo Cesar
Tipo de recurso:
Article of investigation
Fecha de publicación:
2018
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
eng
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/25893
Acceso en línea:
http://hdl.handle.net/10495/25893
Palabra clave:
Neoplasias Hepáticas
Liver Neoplasms
Trasplante de Hígado
Liver Transplantation
Rights
openAccess
License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Description
Summary:ABSTRACT: Background and aims. Background and aims. Heter Background and aims. ogeneous data has been reported regarding liver transplantation (LT) for hepatocellular carcinoma (HCC) in Latin America. We aimed to describe treatment during waiting list, survival and recurrence of HCC after LT in a multicenter study from Latin America. Material and methods. Material and methods. Patients with Material and methods. HCC diagnosed prior to transplant (cHCC) and incidentally found in the explanted liver (iHCC) were included. Imaging-explanted features were compared in cHCC (non-discordant if pre and post-LT were within Milan, discordant if pre-LT was within and post-LT exceeding Milan). Results. Overall, Results.Results. 435 patients with cHCC and 92 with iHCC were included. At listing, 81% and 91% of cHCC patients were within Milan and San Francisco criteria (UCSF), respectively. Five-year survival and recurrence rates for cHCC within Milan, exceeding Milan/within UCSF and beyond UCSF were 71% and 16%; 66% and 26%; 46% and 55%, respectively. Locoregional treatment prior to LT was performed in 39% of cHCC within Milan, in 53% beyond Milan/within UCSF and in 83% exceeding UCSF (p < 0.0001). This treatment difference was not observed according to AFP values (d100, 44%; 101-1,000, 39%, and > 1,000 ng/mL 64%; p = 0.12). Discordant imaging-explanted data was observed in 29% of cHCC, showing lower survival HR 2.02 (CI 1.29; 3.15) and higher recurrence rates HR 2.34 when compared to AFP <100 ng/mL. Serum AFP > 1,000 ng/mL at listing was independently associated with a higher 5-year recurrence rate and a HR of 3.24 when compared to AFP <100 ng/mL. Conclusion. Although overall r Conclusion.Conclusion. esults are comparable to other regions worldwide, preLT treatment not only considering imaging data but also AFP values should be contemplated during the next years.