Dados do Trabalho

Título

Analysis of prognostic and predictive factors of post recurrence survival after liver transplantation for hepatocellular carcinoma: a multicenter cohort study from Latin America

Introdução

Patients with recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) have been excluded from first and second line trials of systemic treatments of HCC. In the daily practice, many of these patients are treated with antiangiogenics or other therapies. We aimed to assess prognostic and predictive variables of post recurrence survival in a Latin American cohort study.

Material e Método

This multicenter study conducted in Latin America included adult patients who received a first LT for HCC between years 2005-2018. Post progression survival (or post recurrence survival) was considered as the main end-point .Type of HCC recurrence at diagnosis was registered: liver, extrahepatic (lungs, bones, other metastasis). Associated exposure variables with post progression survival were evaluated by a multivariable Cox regression analysis, with Hazard Ratios (HR) and 95% confidence intervals calculated (95% CI)

Resultados

Overall, treatment after recurrence was performed in 55.2% of the patients (n=58/105). After adjusting this prognostic factor with predictive variables after treatment of HCC recurrence, any locorregional therapy (surgery/TACE) HR 0.29 (CI 0.14;0.61; P=0.001) and treatment with sorafenib HR 0.36 (CI 0.22;0.59; P<0.0001) were independently associated with better post recurrence survival. Independent prognostic variables at HCC recurrence diagnosis were evaluated and the only tumor factor associated with worst post progression survival was early recurrence with an adjusted HR of 1.92 (CI 1.22; 3.03)

Discussão e Conclusões

In this Latin American cohort, the only prognostic factor associated with post progression survival was early recurrence presentation. However, the effect of first line systemic treatment was independent from this worst time-point presentation

Palavras Chave

liver transplantation, AFP