title: Hepatic artery chemoembolization for hepatocellular carcinoma in patients listed for liver transplantation.
abstract: We retrospectively analyzed all listed patients having hepatic artery chemoembolization (HACE) for hepatocellular carcinoma (HCC) stage T2 or less. Outcomes were transplantation, waiting list removal, death, and HCC recurrence. Twenty patients (mean age 55.7 years; 15 males) were identified. Twelve (60%) were transplanted, seven (35%) were removed from the list and one (5%) remains listed. Fourteen (70%) are alive. All 12 transplanted patients are alive (mean 2.94 years); one of seven removed from the list is alive (mean 1.45 years). Survival was significantly higher for those transplanted or listed vs. removed from the list (100% vs. 14.3%, p = 0.0002). No HCC's recurred. Three patients (15%) were removed from the list after prolonged waiting times before MELD. Hepatic artery chemoembolization induced deterioration and removal from the list of one (5%) patient. Survival for those transplanted was excellent(100%), but overall survival was significantly lower (61.3%) at a mean 5.48 years. Hepatic artery chemoembolization for listed patients with <or=euro T2 stage HCC is beneficial, but must be weighed against decreased waiting times and risk of HACE-induced deterioration. This balance is influenced greatly by the MELD system's determination of waiting times for HCC patients.
authors.affiliation: Division of Gastroenterology, University of Colorado Health Sciences Center, Denver, CO, USA. hayaship@slu.edu
authors.forename: Paul H
authors.initials: PH
authors.lastname: Hayashi
authors.forename: Michael
authors.initials: M
authors.lastname: Ludkowski
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Forman
authors.forename: Michael
authors.initials: M
authors.lastname: Osgood
authors.forename: Stephen
authors.initials: S
authors.lastname: Johnson
authors.forename: Marcelo
authors.initials: M
authors.lastname: Kugelmas
authors.forename: James F
authors.initials: JF
authors.lastname: Trotter
authors.forename: Thomas
authors.initials: T
authors.lastname: Bak
authors.forename: Michael
authors.initials: M
authors.lastname: Wachs
authors.forename: Igal
authors.initials: I
authors.lastname: Kam
authors.forename: Janette
authors.initials: J
authors.lastname: Durham
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Everson
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery* / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D005260:Female; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery* / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D013534:Survival