Detailed Abstract
[Poster Presentation 5 - Liver (Liver Disease/Surgery)]
[LV PP 5-S1] Outcomes in Liver Recipients with Hepatocellular Carcinoma And Combined Portal Vein Tumor Thrombosis, Multicenter Study
Jae Geun LEE 1, Hee Dong JHO 1, Suk Kyun HONG 1, Hae Won LEE 1, Kwang Ho YANG 1, Jong Man KIM 1
1 Department of Surgery, Severance Hospital, REPUBLIC OF KOREA, 2 Department of Surgery, Asan Medical Center, REPUBLIC OF KOREA, 3 Department of Surgery, Seoul National University Hospital, REPUBLIC OF KOREA, 4 Department of Surgery, Seoul National University Bundang Hospital, REPUBLIC OF KOREA, 5 Department of Surgery, Pusan National University Yangsan Hospital, REPUBLIC OF KOREA, 6 Department of Surgery, Samsung Medical Center, REPUBLIC OF KOREA
Background : Liver transplant (LT) recipients facing an increased risk of hepatocellular carcinoma (HCC) recurrence due to concurrent portal vein tumor thrombosis (PVTT) often undergo liver transplantation, despite general discouragement. This study aims to investigate and offer insights into the practice of liver transplantation in such cases, given the absence of a standardized consensus.
Methods : A retrospective analysis of 371 LT recipients diagnosed with HCC and PVTT across six major Korean hospitals evaluated patient demographics, pre-transplant characteristics, and post-transplant outcomes. Prognostic factors, including tumor stage, vascular invasion, PVTT level, tumor marker, and treatment modalities, were examined for their impact on overall survival (OS) and disease-free survival (DFS).
Results : OS and DFS rates demonstrated variations based on the extent of PVTT. Independent risk factors for HCC recurrence included microvascular invasion (HR 2.536, 95% CI 1.637-3.929, P< 0.001), adjacent organ or hepatic vein invasion (HR 2.220, 95% CI 1.402-3.515, P< 0.001), sum of HCC size ≥ 9 cm (HR 2.094, 95% CI 1.470-2.984, P < 0.001), and disease progression in image response (HR 1.864, 95% CI 1.186-2.932, P = 0.007). OS and DFS rates varied significantly based on the number of risk factors (both P<0.001). Even in PVTT patients with zero risk factors, the 10-year OS and DFS rates after liver transplantation were 69.9% and 62.1%, respectively.
Conclusions : This study identified risk factors for LT recipients with HCC and PVTT, emphasizing the prognostic significance of preoperative factors like HCC size, adjacent organ and hepatic vein invasion, disease progression in image response, and PVTT level
Methods : A retrospective analysis of 371 LT recipients diagnosed with HCC and PVTT across six major Korean hospitals evaluated patient demographics, pre-transplant characteristics, and post-transplant outcomes. Prognostic factors, including tumor stage, vascular invasion, PVTT level, tumor marker, and treatment modalities, were examined for their impact on overall survival (OS) and disease-free survival (DFS).
Results : OS and DFS rates demonstrated variations based on the extent of PVTT. Independent risk factors for HCC recurrence included microvascular invasion (HR 2.536, 95% CI 1.637-3.929, P< 0.001), adjacent organ or hepatic vein invasion (HR 2.220, 95% CI 1.402-3.515, P< 0.001), sum of HCC size ≥ 9 cm (HR 2.094, 95% CI 1.470-2.984, P < 0.001), and disease progression in image response (HR 1.864, 95% CI 1.186-2.932, P = 0.007). OS and DFS rates varied significantly based on the number of risk factors (both P<0.001). Even in PVTT patients with zero risk factors, the 10-year OS and DFS rates after liver transplantation were 69.9% and 62.1%, respectively.
Conclusions : This study identified risk factors for LT recipients with HCC and PVTT, emphasizing the prognostic significance of preoperative factors like HCC size, adjacent organ and hepatic vein invasion, disease progression in image response, and PVTT level
SESSION
Poster Presentation 5
Zone F 3/21/2024 2:50 PM - 3:30 PM