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International study on the outcome of locoregional therapy for liver transplant in hepatocellular carcinoma beyond Milan criteria
- Source :
- JHEP Reports, Vol 3, Iss 5, Pp 100331- (2021)
- Publication Year :
- 2021
- Publisher :
- Elsevier, 2021.
-
Abstract
- Background & Aims: Good outcomes after liver transplantation (LT) have been reported after successfully downstaging to Milan criteria in more advanced hepatocellular carcinoma (HCC). We aimed to compare post-LT outcomes in patients receiving locoregional therapies (LRT) before LT according to Milan criteria and University of California San Francisco downstaging (UCSF-DS) protocol and ‘all-comers’. Methods: This multicentre cohort study included patients who received any LRT before LT from Europe and Latin America (2000–2018). We excluded patients with alpha-foetoprotein (AFP) above 1,000 ng/ml. Competing risk regression analysis for HCC recurrence was conducted, estimating subdistribution hazard ratios (SHRs) and corresponding 95% CIs. Results: From 2,441 LT patients, 70.1% received LRT before LT (n = 1,711). Of these, 80.6% were within Milan, 12.0% within UCSF-DS, and 7.4% all-comers. Successful downstaging was achieved in 45.2% (CI 34.8–55.8) and 38.2% (CI 25.4–52.3) of the UCSF-DS group and all-comers, respectively. The risk of recurrence was higher for all-comers (SHR 6.01 [p
Details
- Language :
- English
- ISSN :
- 25895559
- Volume :
- 3
- Issue :
- 5
- Database :
- Directory of Open Access Journals
- Journal :
- JHEP Reports
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.29730cd61a4a4d3bb1d30f65270c26a9
- Document Type :
- article
- Full Text :
- https://doi.org/10.1016/j.jhepr.2021.100331