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. 2017 Nov-Dec;23(6):441-447.
doi: 10.5152/dir.2017.17106.

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

Dimitri Dorcaratto  1 , Venkatesha Udupa, Niamh M Hogan, David P Brophy, Jeffrey W McCann, Donal Maguire, Justin Geoghegan, Colin P Cantwell, Emir Hoti
Affiliations

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

Dimitri Dorcaratto et al. Diagn Interv Radiol. 2017 Nov-Dec.

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.

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Conflict of interest statement

Conflict of interest disclosure

The authors declared no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier overall survival (OS) curves for patients who did and did not have doxorubicin drug-eluting bead transarterial chemoembolization (DEB-TACE) before orthotopic liver transplantation.
Figure 2
Figure 2
Kaplan-Meier disease-free survival (DFS) curves for patients who did and did not have doxorubicin drug-eluting bead transarterial chemoembolization (DEB-TACE) before orthotopic liver transplantation.
See this image and copyright information in PMC

References

    1. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334:693–699. https://doi.org/10.1056/NEJM199603143341104. - DOI - PubMed
    1. Clavien PA, Lesurtel M, Bossuyt PM, Gores GJ, Langer B, Perrier A. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. Lancet Oncol. 2012;13:e11–22. https://doi.org/10.1016/S1470-2045(11)70175-9. - DOI - PMC - PubMed
    1. Forner A, Llovet JM, Bruix J. Chemoembolization for intermediate HCC: is there proof of survival benefit? J Hepatol. 2012;56:984–986. https://doi.org/10.1016/j.jhep.2011.08.017. - DOI - PubMed
    1. Oliveri RS, Wetterslev J, Gluud C. Transarterial (chemo)embolisation for unresectable hepatocellular carcinoma. Cochrane Database Syst Rev. 2011:CD004787. https://doi.org/10.1002/14651858.CD004787.pub2. - DOI - PMC - PubMed
    1. Brunello F, Veltri A, Carucci P, et al. Radiofrequency ablation versus ethanol injection for early hepatocellular carcinoma: A randomized controlled trial. Scand J Gastroenterol. 2008;43:727–735. https://doi.org/10.1080/00365520701885481. - DOI - PubMed