Bridging treatment prior to liver transplantation for hepatocellular carcinoma: radioembolization or transarterial chemoembolization?
Abstract Background In hepatocellular carcinoma (HCC) patients, intraarterial therapies are regularly employed as a bridge to liver transplantation to prevent tumor progression during waiting time. Objective of this study was to compare HCC recurrence after liver transplantation following TACE or ra...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-022-00708-w |
| _version_ | 1818213523489030144 |
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| author | Tamás Benkö Julia König Jens M. Theysohn Clemens Schotten Fuat H. Saner Jürgen Treckmann Sonia Radunz |
| author_facet | Tamás Benkö Julia König Jens M. Theysohn Clemens Schotten Fuat H. Saner Jürgen Treckmann Sonia Radunz |
| author_sort | Tamás Benkö |
| collection | DOAJ |
| description | Abstract Background In hepatocellular carcinoma (HCC) patients, intraarterial therapies are regularly employed as a bridge to liver transplantation to prevent tumor progression during waiting time. Objective of this study was to compare HCC recurrence after liver transplantation following TACE or radioembolization bridging treatment. Methods We retrospectively analyzed prospectively collected data on 131 consecutive HCC patients who underwent liver transplantation between January 2007 and December 2017 at our liver transplant center (radioembolization n = 44, TACE n = 87). Multivariable logistic regression and cox proportional hazard regression models were used to evaluate factors associated with tumor recurrence and post-transplant survival. Results Between groups, patients were comparable with regards to age and gender. In the radioembolization group, Milan criteria for HCC were met significantly less frequently (20.5% vs. 65.5%, p < 0.0001). Patients in the radioembolization group required significantly fewer intraarterial treatments (1 [1–2] vs. 1 [1–7], p = 0.0007). On explant specimen, tumor differentiation, microvascular invasion and tumor necrosis were comparable between the groups. HCC recurrence and overall survival were similar between the groups. Multivariable analysis detected increasing recipient age, male gender, complete tumor necrosis and absence of microvascular invasion being independently associated with decreased odds for HCC recurrence. Increasing model of end-stage liver disease (MELD) score and tumor recurrence were independently associated with increased odds of post-transplant death. Conclusions Intraarterial bridging treatment leading to tumor necrosis may not only prevent waitlist drop-out but also facilitate long-term successful liver transplantation in HCC patients. Both radioembolization and TACE represent potent treatment strategies. |
| first_indexed | 2024-12-12T06:05:39Z |
| format | Article |
| id | doaj.art-56aba72bf7184b96a129c2bf5e86748a |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-12-12T06:05:39Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-56aba72bf7184b96a129c2bf5e86748a2022-12-22T00:35:18ZengBMCEuropean Journal of Medical Research2047-783X2022-05-012711810.1186/s40001-022-00708-wBridging treatment prior to liver transplantation for hepatocellular carcinoma: radioembolization or transarterial chemoembolization?Tamás Benkö0Julia König1Jens M. Theysohn2Clemens Schotten3Fuat H. Saner4Jürgen Treckmann5Sonia Radunz6Department of General, Visceral and Transplant Surgery, University Hospital EssenDepartment of General, Visceral and Transplant Surgery, University Hospital EssenDepartment of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenDepartment of Gastroenterology and Hepatology, University Hospital EssenDepartment of General, Visceral and Transplant Surgery, University Hospital EssenDepartment of General, Visceral and Transplant Surgery, University Hospital EssenDepartment of General, Visceral and Transplant Surgery, University Hospital EssenAbstract Background In hepatocellular carcinoma (HCC) patients, intraarterial therapies are regularly employed as a bridge to liver transplantation to prevent tumor progression during waiting time. Objective of this study was to compare HCC recurrence after liver transplantation following TACE or radioembolization bridging treatment. Methods We retrospectively analyzed prospectively collected data on 131 consecutive HCC patients who underwent liver transplantation between January 2007 and December 2017 at our liver transplant center (radioembolization n = 44, TACE n = 87). Multivariable logistic regression and cox proportional hazard regression models were used to evaluate factors associated with tumor recurrence and post-transplant survival. Results Between groups, patients were comparable with regards to age and gender. In the radioembolization group, Milan criteria for HCC were met significantly less frequently (20.5% vs. 65.5%, p < 0.0001). Patients in the radioembolization group required significantly fewer intraarterial treatments (1 [1–2] vs. 1 [1–7], p = 0.0007). On explant specimen, tumor differentiation, microvascular invasion and tumor necrosis were comparable between the groups. HCC recurrence and overall survival were similar between the groups. Multivariable analysis detected increasing recipient age, male gender, complete tumor necrosis and absence of microvascular invasion being independently associated with decreased odds for HCC recurrence. Increasing model of end-stage liver disease (MELD) score and tumor recurrence were independently associated with increased odds of post-transplant death. Conclusions Intraarterial bridging treatment leading to tumor necrosis may not only prevent waitlist drop-out but also facilitate long-term successful liver transplantation in HCC patients. Both radioembolization and TACE represent potent treatment strategies.https://doi.org/10.1186/s40001-022-00708-wBridging treatmentHepatocellular carcinomaLiver transplantationRadioembolizationTransarterial chemoembolization |
| spellingShingle | Tamás Benkö Julia König Jens M. Theysohn Clemens Schotten Fuat H. Saner Jürgen Treckmann Sonia Radunz Bridging treatment prior to liver transplantation for hepatocellular carcinoma: radioembolization or transarterial chemoembolization? European Journal of Medical Research Bridging treatment Hepatocellular carcinoma Liver transplantation Radioembolization Transarterial chemoembolization |
| title | Bridging treatment prior to liver transplantation for hepatocellular carcinoma: radioembolization or transarterial chemoembolization? |
| title_full | Bridging treatment prior to liver transplantation for hepatocellular carcinoma: radioembolization or transarterial chemoembolization? |
| title_fullStr | Bridging treatment prior to liver transplantation for hepatocellular carcinoma: radioembolization or transarterial chemoembolization? |
| title_full_unstemmed | Bridging treatment prior to liver transplantation for hepatocellular carcinoma: radioembolization or transarterial chemoembolization? |
| title_short | Bridging treatment prior to liver transplantation for hepatocellular carcinoma: radioembolization or transarterial chemoembolization? |
| title_sort | bridging treatment prior to liver transplantation for hepatocellular carcinoma radioembolization or transarterial chemoembolization |
| topic | Bridging treatment Hepatocellular carcinoma Liver transplantation Radioembolization Transarterial chemoembolization |
| url | https://doi.org/10.1186/s40001-022-00708-w |
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