The Impact of Bridging LRT on Survival in Patients Listed for Liver Transplantation

Peiman Habibollahi, Stephen Hunt, Terence Gade, Mandeep S. Dagli, Jeffrey I. Mondschein, Deepak Sudheendra, S. William Stavropoulos, Michael Soulen, Nadolski Gregory

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Purpose: Locoregional therapy (LRT) is recommended for certain groups of patients with hepatocellular carcinoma (HCC) listed for orthotopic liver transplantation (OLT) with expected wait times greater than 6 months. A retrospective single-center study was performed to evaluate the effect of LRT on the outcomes of patients with HCC listed for OLT. Methods: Institutional database was reviewed to identify the patients listed for OLT with HCC (March 1998–December 2010). Patient and tumor characteristics were recorded with a follow-up period of 6.5 years from diagnosis. Results: Out of 359 listed patients, 72 patients were delisted (delisted group) and 287 underwent orthotopic liver transplantation (OLT group). One hundred fifty-five and 45 patients from the OLT and delisted groups underwent locoregional therapy (LRT), respectively. Median wait time and sum of largest tumor diameter were significantly higher for patients receiving LRT. LRT was associated with significantly better survival among delisted patients at the end of follow-up (1249.6 ± 137.4 vs. 742.1 ± 155.4 days, p = 0.028). In the OLT group, survival was similar between LRT and no LRT group, but survival was significantly better in patients with largest tumor diameter ≥30 mm (1949.4 ± 95.1 vs. 1694.8 ± 135.5, p = 0.02). Conclusion: Patients with HCC and the largest tumor greater than 30 mm treated with LRT prior to OLT have improved survival compared to patients not receiving LRT. Additionally, for patients who did not undergo transplant survival is significantly longer for those receiving LRT.

Original languageEnglish (US)
Pages (from-to)112-119
Number of pages8
JournalCardiovascular and Interventional Radiology
Volume41
Issue number1
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Keywords

  • Bridging therapy
  • Hepatocellular carcinoma
  • Liver transplant
  • Locoregional therapy
  • TACE

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Habibollahi, P., Hunt, S., Gade, T., Dagli, M. S., Mondschein, J. I., Sudheendra, D., Stavropoulos, S. W., Soulen, M., & Gregory, N. (2018). The Impact of Bridging LRT on Survival in Patients Listed for Liver Transplantation. Cardiovascular and Interventional Radiology, 41(1), 112-119. https://doi.org/10.1007/s00270-017-1759-1