1. Impact of remnant vital tissue after locoregional treatment and liver transplant in hepatocellular cancer patients. A multicentre cohort study
- Author
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Marina Scarpelli, Daniele Nicolini, Tahir Shah, Quirino Lai, Samuele Iesari, M. Thamara P. R. Perera, Claudia Quaranta, Antonio Orlacchio, Jan Lerut, Giuseppe Tisone, Mina Komuta, Tommaso Maria Manzia, Marco Vivarelli, Mario Angelico, Roberta Angelico, Amanda Carvalheiro, Giampiero Palmieri, Roberto Montalti, Manzia, Tommaso M, Lai, Quirino, Iesari, Samuele, Perera, M Thamara P R, Komuta, Mina, Carvalheiro, Amanda, Shah, Tahir, Angelico, Roberta, Quaranta, Claudia, Nicolini, Daniele, Montalti, Roberto, Scarpelli, Marina, Palmieri, Giampiero, Orlacchio, Antonio, Vivarelli, Marco, Angelico, Mario, Lerut, Jan, Tisone, Giuseppe, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, and UCL - (SLuc) Service d'anatomie pathologique
- Subjects
Target lesion ,medicine.medical_specialty ,recurrence ,Milan Criteria ,medicine.medical_treatment ,Hepatocellular carcinoma ,liver transplantation ,locoregional treatment ,Milan criteria ,transplantation ,Liver transplantation ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Risk factor ,Pathological ,Transplantation ,business.industry ,Proportional hazards model ,hepatocellular carcinoma ,medicine.disease ,Settore MED/18 - Chirurgia Generale ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,Cohort study - Abstract
The role of pathological findings after locoregional treatments as predictors of hepatocellular cancer recurrence after liver transplantation has been poorly addressed. The aim of the study was to identify the role of remnant vital tissue (RVT) of the target lesion in predicting hepatocellular cancer recurrence. Two hundred and seventy-six patients firstly undergoing locoregional treatment and then transplanted between January 2010 and December 2015 in four European Transplant Centres (i.e. Rome Tor Vergata, Birmingham, Brussels and Ancona) were enrolled in the study to investigate the role of pathological response at upfront locoregional treatment. At multivariable Cox regression analysis, RVT ≥2 cm was a strong independent risk factor for post-LT recurrence (HR = 5.6; P < 0.0001). Five-year disease-free survival rates were 60.8%, 80.9% and 95.0% in patients presenting a RVT ≥2 cm vs. 0.1-1.9 vs. no RVT, respectively. When only Milan Criteria-IN patients were analysed, similar results were reported, with 5-year disease-free survival rates of 58.1%, 79.0% and 94.0% in patients presenting a RVT ≥2 cm vs. 0.1-1.9 vs. no RVT, respectively. RVT is an important determinant of tumour recurrence after liver transplantation performed for hepatocellular cancer. Its discriminative power looks to be evident also in a Milan-IN setting, suggesting to more liberally use locoregional treatments also in these patients.
- Published
- 2018