No apparent benefit of preemptive sorafenib therapy in liver transplant recipients with advanced hepatocellular carcinoma on explant

• Published in: Clinical transplantation 2018-05, Vol.32 (5), p.e13246-n/a
• Main Authors: Satapathy, Sanjaya K., Das, Kanak, Kocak, Mehmet, Helmick, Ryan A., Eason, James D., Nair, Satheesh P., Vanatta, Jason M.
• Format: Article
• Language: English
• Subjects: adjuvant therapy; epidemiology; graft survival; liver transplant; malignant; Milan criteria; sorafenib
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.13246

Background Sorafenib has shown survival benefits in patients with advanced HCC; however, limited data are available on its role in OLT recipients with advanced HCC in the explant. Aim Evaluate the role of preemptive sorafenib therapy on HCC recurrence and survival after OLT with advanced HCC on explant pathology. Methods We retrospectively reviewed the outcome after OLT of all HCC recipients with advanced HCC in the explant pathology from 04/2006 to 12/2012 based on preemptive treatment with sorafenib. Results During the observation period, 217 HCC recipients underwent OLT; 50 explants revealed advanced HCC. After exclusion of 5 patients who were lost to follow‐up, 45 LT recipients were finally included for analysis. Recipients were grouped as sorafenib Gr (N = 25) and nonsorafenib Gr (N = 20). Both recurrence‐free survival (RFS) (P = .67) and overall survival were similar between groups (P = .53) on Kaplan‐Meier analysis. Additionally, sorafenib use was neither associated with HCC recurrence‐free survival (HR 0.74, 95% CI [0.32‐1.70]; P = .48) nor overall survival (HR 0.92, 95% CI [0.39‐2.15], P = .84) on multivariate Cox proportional hazard model with sorafenib use as time‐varying covariates. Conclusion Preemptive treatment with sorafenib in OLT recipients with high‐risk features in explant does not improve HCC recurrence‐free or overall survival.