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• W3007844479 abstract "Despite curative intent of liver transplant (LT), hepatocellular carcinoma (HCC) recurs in 15% of patients. Recurrence is confined to the liver in < 30%, indicating that tumor recurrence is mostly a systemic process in immunosuppressed patients. This portends a poor prognosis (7-16 months post recurrence), especially when the liver is involved. In this study we investigate the safety and efficacy of Radioembolization (Y90) for treating HCC following LT. With IRB approval, this is a multicenter retrospective chart review of HCC patients who received Y90 post-LT. Exploratory analysis was conducted to identify patterns and characteristics of HCC recurrence and safety/efficacy of Y90 in post-LT patients. Overall survival was estimated from date of Y90 using Kaplan-Meier method. 18 patients with median age 66 (range, 47–72) years were included (LT 1995-2017). 15 (83%) patients had LT for HCC and 3 (17%) secondary to end-stage liver disease. At explant, 10 (56%) were within Milan criteria: 3 (17%), 7 (39%), 3 (17%), and 2 (11%) had T1, T2, T3 and T4 tumors, respectively. Nine (50%) patients first developed local hepatic recurrence, and 6 (33%) first developed metastatic recurrence; median time to overall recurrence was 26.8 (5.2 – 145) months post-LT and median time to hepatic recurrence was 45.3 (5.2 – 214) months post-LT. Of those that did not have HCC prior to LT, de-novo tumors developed 60, 110, and 249 months post-LT. Median time to Y90 was 3.5 (1-13.7) months from hepatic recurrence. On day of Y90, 14 (78%) and 4 (22%) patients had Child-Pugh A and B, respectively, and median tumor size was 3.5 (1.2 – 15) cm. 11 (61%) had solitary tumors. 10 (56%), 7 (39%) and 1 (5%) patients received 1, 2 and 3 treatments respectively. There was no incidence of grade 3 or 4 hepatotoxicity within 3-months of Y90. Median OS from date of diagnosis of recurrence was 31 (13.8 – 46.9) months, 16.1 (13.8-33) months from date of hepatic recurrence, and 11.3 (CI: 9.5 – 30) months from day of Y90. Y90 in LT patients is safe. HCC recurrence post-LT tends to be aggressive where OS becomes shorter once liver is involved. Targeting hepatic recurrences with Y90 could be an option in such patient" @default.
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• W3007844479 date "2020-03-01" @default.
• W3007844479 modified "2023-09-25" @default.
• W3007844479 title "3:36 PM Abstract No. 141 Radioembolization for recurrent hepatocellular carcinoma after liver transplant: a multicenter exploratory analysis" @default.
• W3007844479 doi "https://doi.org/10.1016/j.jvir.2019.12.174" @default.
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