Detailed Abstract
[Liver Best Oral Presentation - Liver (Transplantation)]
[LV BEST OP 4] Long-term outcomes of liver transplantation in hepatocellular carcinoma patients with portal vein tumor thrombosis after downstaging
Sang-Hoon KIM1 , Deok-Bog MOON*1 , Sung-Gyu LEE1 , Hwang SHIN1 , Ki-Hun KIM1 , Chul-Soo AHN1 , Tae-Yong HA1 , Gi-Won SONG1 , Dong-Hwan JUNG1 , Gil-Chun PARK1 , Young-In YOON1 , Woo-Hyoung KANG1 , Hwui-Dong CHO1 , Su-Min HA1 , Byeong-Gon NA1 , Minjae KIM1 , Sung-Min KIM1 , Geunhyeok YANG1 , Rak-Kyun OH1
1 Division Of Liver Transplantation And Hepatobiliary Surgery, Department Of Surgery, Asan Medical Center, University Of Ulsan College Of Medicine, Seoul, REPUBLIC OF KOREA
Background : This study aimed to investigate long-term outcomes and predictive factors associated with recurrence and survival of hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) after downstaging (DS) in liver transplantation (LT).
Methods : This retrospective study included 136 HCC patients with PVTT following LT between 1998 and 2020 at Asan Medical Center. Overall survival (OS) and recurrence-free survival (RFS) were compared according to the radiographic response of DS. “Responder” was defined as the sum of patients who showed either complete response (CR) or partial response
Results : The median follow-up was 33.5 months. The 1-year, 3-year, and 5-year OS were 83.3%, 57.1%, and 53.3%; 1-year, 3-year, and 5-year RFS were 62.1%, 50.8%, and 48.5% respectively. HCC with Vp1 patients showed better OS (P=0.095) and RFS (P=0.041) than those who with HCC and Vp2-4. The responder group (CR, PR; N=74) showed better OS (P<0.001) and RFS (P<0.001) than the non-responder group (SD, PD, or non-DS; N=62). In multivariate analysis, maximum tumor size, non-responder DS, and microvascular and capsular invasion predicted worse OS; initial alpha fetoprotein≥150 ng/mL and non-responder DS predicted worse RFS.
Conclusions : LT is a treatment option for HCC with PVTT to achieve acceptable long-term survival after successful DS. Tumor size less than 3cm, successful DS, absence of microvascular and capsular invasion, and low alpha fetoprotein (<150 ng/mL) were associated with favorable survival.
Methods : This retrospective study included 136 HCC patients with PVTT following LT between 1998 and 2020 at Asan Medical Center. Overall survival (OS) and recurrence-free survival (RFS) were compared according to the radiographic response of DS. “Responder” was defined as the sum of patients who showed either complete response (CR) or partial response
Results : The median follow-up was 33.5 months. The 1-year, 3-year, and 5-year OS were 83.3%, 57.1%, and 53.3%; 1-year, 3-year, and 5-year RFS were 62.1%, 50.8%, and 48.5% respectively. HCC with Vp1 patients showed better OS (P=0.095) and RFS (P=0.041) than those who with HCC and Vp2-4. The responder group (CR, PR; N=74) showed better OS (P<0.001) and RFS (P<0.001) than the non-responder group (SD, PD, or non-DS; N=62). In multivariate analysis, maximum tumor size, non-responder DS, and microvascular and capsular invasion predicted worse OS; initial alpha fetoprotein≥150 ng/mL and non-responder DS predicted worse RFS.
Conclusions : LT is a treatment option for HCC with PVTT to achieve acceptable long-term survival after successful DS. Tumor size less than 3cm, successful DS, absence of microvascular and capsular invasion, and low alpha fetoprotein (<150 ng/mL) were associated with favorable survival.
SESSION
Liver Best Oral Presentation
Room B 3/23/2023 11:00 AM - 12:10 PM