Detailed Abstract
[E-poster - Liver (Transplantation)]
[EP 038] Comparison of Intrahepatic Metastasis And Multicentric Occurrence in Multiple Hepatocellular Carcinoma after Liver Transplantation.
Hwa-Hee KOH 1, Eun-Ki MIN 1, Minyu KANG 1, Seung Hyuk YIM 1, Mun Chae CHOI 1, Young Jin YOO 1, Myoung Soo KIM 1, Dong Jin JOO 1, Deok-Gie KIM 1, Jae Geun LEE 1
1 Surgery, Severance Hospital, REPUBLIC OF KOREA
Background : In the application of liver transplantation(LT) for multiple hepatocellular carcinoma(HCC), criteria such as Milan criteria, UCSF, and up-to-7 emphasize tumor size and number when determining prognosis. However, these criteria do not consider whether the tumors are a result of intrahepatic metastasis(IM) or multicentric occurrence(MO). This study aims to compare these distinctions affect prognosis after LT.
Methods : In this single-center retrospective study, 503 patients who underwent LT for HCC were categorized based on pathology results into two groups; intrahepatic metastasis(IM group, n=52) and multicentric occurrence(MO group, n=200). Recurrence free survival and overall survival were analyzed in entire and 1:2 propensity score-matched group.
Results : In the entire population, disparities were observed between the two groups in the implementation of pretransplant locoregional treatment (IMvs.MO: 86.5%vs.72%, p=0.002). After PSM, no significant differences were found between IM and MO group except tumor differentiation (86.4%vs.27%, p<0.001) and microvascular invasion (61.4%vs.33.8%, p=0.006). In matched population, the five-year overall survival was lower in IM group than MO group (57.7%vs.75.7%, p=0.04). The five-year recurrence free survival was significantly lower in IM group than MO group (41.2%vs.70.2%, p=0.002). The IM group was independently associated with recurrence even after adjusting for various factors related to tumor (HR 4.54, 95% CI 1.20-17.2, p=0.026).
Conclusions : This study revealed that HCC with IM have worse survival and higher recurrence rates post-LT compared to those with MO. This difference persists even when pre-operative tumor characteristics are similar, suggesting that the nature of tumor occurrence is a crucial factor influencing post-transplant outcomes.
Methods : In this single-center retrospective study, 503 patients who underwent LT for HCC were categorized based on pathology results into two groups; intrahepatic metastasis(IM group, n=52) and multicentric occurrence(MO group, n=200). Recurrence free survival and overall survival were analyzed in entire and 1:2 propensity score-matched group.
Results : In the entire population, disparities were observed between the two groups in the implementation of pretransplant locoregional treatment (IMvs.MO: 86.5%vs.72%, p=0.002). After PSM, no significant differences were found between IM and MO group except tumor differentiation (86.4%vs.27%, p<0.001) and microvascular invasion (61.4%vs.33.8%, p=0.006). In matched population, the five-year overall survival was lower in IM group than MO group (57.7%vs.75.7%, p=0.04). The five-year recurrence free survival was significantly lower in IM group than MO group (41.2%vs.70.2%, p=0.002). The IM group was independently associated with recurrence even after adjusting for various factors related to tumor (HR 4.54, 95% CI 1.20-17.2, p=0.026).
Conclusions : This study revealed that HCC with IM have worse survival and higher recurrence rates post-LT compared to those with MO. This difference persists even when pre-operative tumor characteristics are similar, suggesting that the nature of tumor occurrence is a crucial factor influencing post-transplant outcomes.
SESSION
E-poster
E-Session 03/21 ALL DAY