Julia Fadini Margon , Aline Lopes Chagas , Angelo A. Mattos , Márcio A. Diniz , Guilherme E.G. Felga , Ilka F.S.F. Boin , Renato Ferreira da Silva , José Huygens Parente Garcia , Agnaldo Soares Lima , Rita C.M.A. da Silva , Paulo Everton Garcia Costa , Maria Lúcia Zanotelli , Júlio Cezar Uili Coelho , André L.C. Watanabe , Débora Raquel Terrabuio , Paulo Roberto Reichert , Paulo Lisboa Bittencourt , Leila M.M. Beltrão Pereira , Luiz Augusto Carneiro-D'Albuquerque , Flair José Carrilho
{"title":"Impact of bridge therapy for hepatocellular carcinoma in patients submitted to liver transplantation: A Brazilian multicenter study","authors":"Julia Fadini Margon , Aline Lopes Chagas , Angelo A. Mattos , Márcio A. Diniz , Guilherme E.G. Felga , Ilka F.S.F. Boin , Renato Ferreira da Silva , José Huygens Parente Garcia , Agnaldo Soares Lima , Rita C.M.A. da Silva , Paulo Everton Garcia Costa , Maria Lúcia Zanotelli , Júlio Cezar Uili Coelho , André L.C. Watanabe , Débora Raquel Terrabuio , Paulo Roberto Reichert , Paulo Lisboa Bittencourt , Leila M.M. Beltrão Pereira , Luiz Augusto Carneiro-D'Albuquerque , Flair José Carrilho","doi":"10.1016/j.liver.2025.100258","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Hepatocellular carcinoma (HCC) is a main indication for liver transplantation (LT). Bridge therapy (BT) is recommended when waiting time on transplant list is longer than 6 months to prevent dropout. However, the prognostic role of locoregional treatment in post-LT outcomes needs to be better defined. Our aims were to evaluate the impact of BT on post-LT overall survival (OS) and recurrence-free survival (RFS) among LT recipients with HCC.</div></div><div><h3>Materials and Methods</h3><div>Multicenter retrospective cohort study in HCC patients submitted to LT with clinical and radiological data analysis. Clinical features, BT and tumor response according to mRECIST were analyzed. Post-LT OS and RFS according to this were compared.</div></div><div><h3>Results</h3><div>1,119 patients were included. Waiting time on transplant list was longer than 6 months in 49 % of patients and 67 % underwent BT. Transarterial-chemoembolization/embolization were the most common treatments performed (80 %). According to mRECIST, 37 % showed complete response (CR), 38 % partial response (PR), 12 % stable disease (SD) and 13 % progressive disease (PD). The OS was 63 % in 5y in a mean follow-up of 28 months. Post-LT tumor recurrence was 8 %. There were no differences in RFS or OS among patients who underwent or not BT. However, patients who achieved CR had a higher RFS compared to PR, SD or PD (<em>p</em> = 0.019) and the objective response to treatment was an independent predictor of lower recurrence risk.</div></div><div><h3>Conclusions</h3><div>In a large multicentric cohort of LT recipients we observed that patients that achieved CR after BT presented lower risk of post-LT tumor recurrence.</div></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"18 ","pages":"Article 100258"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Liver Transplantation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666967625000017","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction and objectives
Hepatocellular carcinoma (HCC) is a main indication for liver transplantation (LT). Bridge therapy (BT) is recommended when waiting time on transplant list is longer than 6 months to prevent dropout. However, the prognostic role of locoregional treatment in post-LT outcomes needs to be better defined. Our aims were to evaluate the impact of BT on post-LT overall survival (OS) and recurrence-free survival (RFS) among LT recipients with HCC.
Materials and Methods
Multicenter retrospective cohort study in HCC patients submitted to LT with clinical and radiological data analysis. Clinical features, BT and tumor response according to mRECIST were analyzed. Post-LT OS and RFS according to this were compared.
Results
1,119 patients were included. Waiting time on transplant list was longer than 6 months in 49 % of patients and 67 % underwent BT. Transarterial-chemoembolization/embolization were the most common treatments performed (80 %). According to mRECIST, 37 % showed complete response (CR), 38 % partial response (PR), 12 % stable disease (SD) and 13 % progressive disease (PD). The OS was 63 % in 5y in a mean follow-up of 28 months. Post-LT tumor recurrence was 8 %. There were no differences in RFS or OS among patients who underwent or not BT. However, patients who achieved CR had a higher RFS compared to PR, SD or PD (p = 0.019) and the objective response to treatment was an independent predictor of lower recurrence risk.
Conclusions
In a large multicentric cohort of LT recipients we observed that patients that achieved CR after BT presented lower risk of post-LT tumor recurrence.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
