liver transplantation for hepatocellular carcinoma (HCC) may be performed ab initio, primary liver transplantation (PLT), or for HCC recurrence after previous treatments such as liver resection (LR) or radiofrequency ablation (RFA), salvage liver transplantation (SLT). the aim of this study was to evaluate the oncological outcomes of SLT vs. PLT. For this, a retrospective study was carried out on patients undergoing liver transplantation for HCC. the outcomes of PLT were compared with those of SLT. the primary outcome was disease-free survival (DFS). the secondary outcomes included overall survival (OS), cancer-specific survival (CSS), and major postoperative complications. a sub-analysis of SLT-LR and SLT-RFA was also performed. In total, 141 patients were included: 96 underwent PLT and 45 SLT. among the SLT group, 25 patients had undergone previous LR while 20 had had RFA. there were no differences in the major postoperative complications. unadjusted DFS was significantly longer in the PLT group (p = 0.02), as were OS (p = 0.025) and CSS (p = 0.001). there was no difference in DFS between PLT and SLT-LR groups, while a significant difference was found between the PLT and SLT-RFA groups (p = 0.035). nonetheless, DFS was no different between the SLT-LR and SLT-RFA groups. PLT appears to offer superior long-term oncological outcomes to SLT. both SLT-LR and SLT-RFA offer acceptable OS and CSS. further prospective studies are needed to confirm these results, but the re-direction of grafts and transplant philosophy towards PLT rather than SLT may need to be considered.

Anselmo, A., Siragusa, L., Brigato, P., Riccetti, C., Collini, A., Sensi, B., et al. (2023). Primary versus Salvage Liver Transplantation after Curative-Intent Resection or Radiofrequency Ablation for Hepatocellular Carcinoma: Long-Term Oncological Outcomes. CANCERS, 15(20) [10.3390/cancers15205030].

Primary versus Salvage Liver Transplantation after Curative-Intent Resection or Radiofrequency Ablation for Hepatocellular Carcinoma: Long-Term Oncological Outcomes

Anselmo, Alessandro;Siragusa, Leandro;Sensi, Bruno;Tisone, Giuseppe
2023-10-18

Abstract

liver transplantation for hepatocellular carcinoma (HCC) may be performed ab initio, primary liver transplantation (PLT), or for HCC recurrence after previous treatments such as liver resection (LR) or radiofrequency ablation (RFA), salvage liver transplantation (SLT). the aim of this study was to evaluate the oncological outcomes of SLT vs. PLT. For this, a retrospective study was carried out on patients undergoing liver transplantation for HCC. the outcomes of PLT were compared with those of SLT. the primary outcome was disease-free survival (DFS). the secondary outcomes included overall survival (OS), cancer-specific survival (CSS), and major postoperative complications. a sub-analysis of SLT-LR and SLT-RFA was also performed. In total, 141 patients were included: 96 underwent PLT and 45 SLT. among the SLT group, 25 patients had undergone previous LR while 20 had had RFA. there were no differences in the major postoperative complications. unadjusted DFS was significantly longer in the PLT group (p = 0.02), as were OS (p = 0.025) and CSS (p = 0.001). there was no difference in DFS between PLT and SLT-LR groups, while a significant difference was found between the PLT and SLT-RFA groups (p = 0.035). nonetheless, DFS was no different between the SLT-LR and SLT-RFA groups. PLT appears to offer superior long-term oncological outcomes to SLT. both SLT-LR and SLT-RFA offer acceptable OS and CSS. further prospective studies are needed to confirm these results, but the re-direction of grafts and transplant philosophy towards PLT rather than SLT may need to be considered.
18-ott-2023
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MEDS-06/A - Chirurgia generale
English
RFA
downstaging
hepatocarcinoma
liver surgery
salvage transplant
transplant oncology
Anselmo, A., Siragusa, L., Brigato, P., Riccetti, C., Collini, A., Sensi, B., et al. (2023). Primary versus Salvage Liver Transplantation after Curative-Intent Resection or Radiofrequency Ablation for Hepatocellular Carcinoma: Long-Term Oncological Outcomes. CANCERS, 15(20) [10.3390/cancers15205030].
Anselmo, A; Siragusa, L; Brigato, P; Riccetti, C; Collini, A; Sensi, B; Tisone, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/396773
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