Introduction Pretransplant transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) has proven to be an effective means of reducing tumor number and volume. Its impact on post-liver transplant patient survival has yet to be demonstrated. This study analyzes single center data on 111 liver transplant patients with explant HCC and minimum 1-year follow-up to evaluate the clinical efficacy of TACE.
Methods Results from 698 liver transplants performed at Indiana University between 2001 and 2006 were reviewed. Explant pathology confirmed 133 patients with HCC. Survival analysis was performed on 111 patients with a minimum 1-year follow-up. The 39 (35%) recipients who had received chemoembolization were compared with the 72 (65%) who had not. Outcomes included reduction in tumor size and number and 1-year patient survival. Kaplan-Meier survival analysis included statistical testing by log rank test with significant p value < .05.
Results One-year survival for patients undergoing TACE was 89.7% versus 86.1% for those not undergoing this procedure (p = NS), in spite of a higher average pathologic stage for TACE patients. TACE did result in a significant decrease in both number and volume of tumor burden. Median time between TACE and transplant was 66 days.
Conclusions Kaplan-Meier survival curve demonstrates an improved survival for TACE patients, in spite of a higher stage HCC. TACE may not impact 1-year survival when time to transplant is very short but may have improved survival thereafter.
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