Liver Transplantation is a Preferable Alternative to Palliative Therapy for Selected Patients with Advanced Hepatocellular Carcinoma

Background Patients with hepatocellular carcinoma (HCC) beyond the traditional criteria (advanced HCC) are typically offered palliation, which is associated with a 3-year survival rate lower than 30%. This study aimed to describe the outcomes for a subset of patients with advanced HCC who satisfied...

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Bibliographic Details
Published in:Annals of surgical oncology 2017-07, Vol.24 (7), p.1843-1851
Main Authors: Aravinthan, Aloysious D., Bruni, Silvio G., Doyle, Adam C., Thein, Hla-Hla, Goldaracena, Nicolas, Issachar, Assaf, Lilly, Leslie B., Selzner, Nazia, Bhat, Mamatha, Sreeharsha, Boraiah, Selzner, Markus, Ghanekar, Anand, Cattral, Mark S., McGilvray, Ian D., Greig, Paul D., Renner, Eberhard L., Grant, David R., Sapisochin, Gonzalo
Format: Article
Language:English
Subjects:
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Female
Follow-Up Studies
Hepatobiliary Tumors
Hepatocellular carcinoma
Humans
Immunology
Liver cancer
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Liver Transplantation
Liver transplants
Male
Medicine
Medicine & Public Health
Middle Aged
Oncology
Palliation
Palliative Care
Patient Selection
Retrospective Studies
Surgery
Surgical Oncology
Survival Rate
Treatment Outcome
Tumor Burden
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Summary:Background Patients with hepatocellular carcinoma (HCC) beyond the traditional criteria (advanced HCC) are typically offered palliation, which is associated with a 3-year survival rate lower than 30%. This study aimed to describe the outcomes for a subset of patients with advanced HCC who satisfied the Extended Toronto Criteria (ETC) and were listed for liver transplantation (LT). Methods All patients listed in the Toronto liver transplantation program with HCC beyond both the Milan and University of California, San Francisco criteria were included in this study. Data were extracted from the prospectively collected electronic database. All radiologic images were reviewed by two independent radiologists. The primary end point was patient survival. Results Between January 1999 and August 2014, 96 patients with advanced HCC were listed for LT, and 62 (65%) of these patients received bridging therapy while on the waiting list. Bridging therapy led to a significant reduction in tumor progression ( p  = 0.02) and tumor burden ( p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-017-5789-3