Does neoadjuvant doxorubicin drug—eluting bead transarterial chemoembolization improve survival in patients undergoing liver transplant for hepatocellular carcinoma?

Abstract

PURPOSE Venkatesha Udupa We aimed to compare the overall (OS) and disease—free survival (DFS) of patients undergoing Nİamh Hogan orthotopic liver transplant (OLT) for hepatocellular carcinoma who did and did not have neoad— juvant doxorubicin drug—eluting bead transarterial chemoembolization (DEB—TACE). Davıd P. Brophy Jeffrey W. McCann METHODS This is retrospective study of 94 patients with HCC transplanted between 2000 and 2014 in ona aguıre single tertiary center. Pre— and postoperative features, DFS and OS were compared between Justin Geog hegan patients who received pre—OLT DEB-TACE (n=34, DEB-TACE group) and those who did not (n=60, Colin Cantwell non-TACE group). Radiologic and histologic response to neoadjuvant treatment as well as its complications were also studied. Emir Hoti RESULTS There were no significant differences in post—transplantation DFS and OS rates between groups (5— year DFS: 70% in DEB-TACE group vs. 63% in non-TACE group, 0.454; 5-year 05: 70% in DEB-TACE group vs. 65% in non-TACE group, P= 0.532).The DEB—TACE group had longer OLT waiting time com— pared with the non—TACE group (110 vs. 72 days; 0.01). On univariate and multivariate analyses, alpha—fetoprotein (AFP) levels >500 ng/mL prior to OLT were associated with decreased OS and DFS regardless of neoadjuvant approach (hazard ratio of 6, P= 0.001 and 5.5, P= 0.002, respectively). CONCLUSION Patients who underwent neoadjuvant DEB—TACE and OLT for hepatocellular carcinoma had no statistically different OS or DFS at and years from patients undergoing OLT alone.