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- W2792904077 abstract "To evaluate the impact of post-Y90 radioembolization (Y90) pathological necrosis in hepatocellular carcinoma (HCC) on overall survival (OS) and recurrence free survival (RFS) following liver transplantation (LT). In this IRB approved study, 170 consecutive HCC patients underwent LT after bridging/downstaging by Y90 between 2004 and 2017. On the date of LT, pathologic analysis of the explants was performed. Necrosis was reported as complete (CN) (no viable HCC), extensive (EN) (50-99% necrosis) and partial necrosis (<50%). Recurrence-free survival (RFS) and overall survival (OS) were calculated using Kaplan Meier Method from date of LT. Log-rank test was used to compare the OS and RFS of between CN, EN and PN. 170 patients underwent LT after Y90, with a median time to LT of 7.4 months (IQR: 4.4-10.3). Three-month mortality rate after LT was 6/170 (3.5%). 75 (44%), 49 (29%) and 46 (27%) patients showed CN, EN, and PN on explant pathologic assessment. Three, five and ten-year OS rates were 86%, 80%, and 56% respectively. 20 patients developed recurrence, with 3, 5 and 10-year RFS rates of 79%, 67% and 40%. Median RFS was 119 (95%CI: 68-119) months. There was a significant difference in the number of recurrences and RFS between patients who had CN or EN vs. patients who had PN [p<0.0001]. Recurrence was seen in 2/75 (3%) patients with CN, 4/49 (8%) patients with EN, and 14/46 (30%) patients with PN [(Chi-squared = 22.04) [p<0.0001]. Median time to recurrence in patients who had PN was 58 months (95%CI 37-58), while it was not reached at 10 years for patients who had CN or EN [p<0.0001]. There was no statistically significant difference in OS of patients who had CN. EN, or PN [p = 0.39]. However, pathological response to treatment showed statistically significant improvement in RFS [p = 0.03]. LT after Y90 represents a curative treatment for HCC with excellent OS rates comparable to LT for non-malignant causes. Patients who achieved EN or CN have improved RFS compared to patients with PN." @default.
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- W2792904077 date "2018-04-01" @default.
- W2792904077 modified "2023-10-14" @default.
- W2792904077 title "3:45 PM Abstract No. 86 Improved post-transplant outcomes in patients achieving pathological necrosis following radioembolization of hepatocellular carcinoma" @default.
- W2792904077 doi "https://doi.org/10.1016/j.jvir.2018.01.099" @default.
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