Does neoadjuvant doxorubicin drug-eluting bead transarterial chemoembolization improve survival in patients undergoing liver transplant for hepatocellular carcinoma?
Diagn Interv Radiol
; 23(6): 441-447, 2017.
Article
en En
| MEDLINE
| ID: mdl-29063856
ABSTRACT
PURPOSE:
We aimed to compare the overall (OS) and disease-free survival (DFS) of patients undergoing orthotopic liver transplant (OLT) for hepatocellular carcinoma who did and did not have neoadjuvant doxorubicin drug-eluting bead transarterial chemoembolization (DEB-TACE).METHODS:
This is a retrospective study of 94 patients with HCC transplanted between 2000 and 2014 in a single tertiary center. Pre- and postoperative features, DFS and OS were compared between patients who received pre-OLT DEB-TACE (n=34, DEB-TACE group) and those who did not (n=60, non-TACE group). Radiologic and histologic response to neoadjuvant treatment as well as its complications were also studied.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, P = 0.454; 5-year OS 70% in DEB-TACE group vs. 65% in non-TACE group, P = 0.532). The DEB-TACE group had longer OLT waiting time compared with the non-TACE group (110 vs. 72 days; P = 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 3 and 5 years from patients undergoing OLT alone.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Doxorrubicina
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Trasplante de Hígado
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Quimioembolización Terapéutica
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Carcinoma Hepatocelular
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Terapia Neoadyuvante
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Neoplasias Hepáticas
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Diagn Interv Radiol
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
RADIOLOGIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Irlanda