title: Does additional doxorubicin chemotherapy improve outcome in patients with hepatocellular carcinoma treated by liver transplantation?
abstract: The aim of this prospective randomized study was to determine whether additional doxorubicin chemotherapy improves outcome in patients with hepatocellular carcinoma (HCCA) treated by liver transplantation. Stratification parameters were tumor stage (UICC I-IVa), gender, age 50 years, alpha-fetoprotein 20 ng/mL, cirrhosis and HbsAg status. For pre-operative chemotherapy doxorubicin (15 mg/m2) was given biweekly, intra-operative chemotherapy was a single dose administered before surgical manipulation. Post-operative chemotherapy from day 10 was as given preoperatively for a total dosage of 300 mg/m2. Outcome parameters were overall survival (OS) and disease-free survival. Of the 75 consecutive patients who received liver transplantation for treatment of HCCA, 62 patients were enrolled. Thirty-four patients were randomized in the chemotherapy group; 28 patients were in the control group and transplanted only. OS rates at 5 years were 38% in the chemotherapy group and 40% in the control group, disease-free survival rates at 5 years 43% and 53%, respectively. Tumor stage and vascular invasion were identified as independent risk factors for recurrence of disease. Doxorubicin chemotherapy did not improve organ survival and disease-free survival in patients undergoing liver transplantation for HCCA.
authors.affiliation: University Hospital of Vienna, Department of Transplant Surgery, Vienna, Austria. herwig.pokorny@meduniwien.ac.at
authors.forename: Herwig
authors.initials: H
authors.lastname: Pokorny
authors.forename: Michael
authors.initials: M
authors.lastname: Gnant
authors.forename: Susanne
authors.initials: S
authors.lastname: Rasoul-Rockenschaub
authors.forename: Bernd
authors.initials: B
authors.lastname: Gollackner
authors.forename: Birgit
authors.initials: B
authors.lastname: Steiner
authors.forename: Günter
authors.initials: G
authors.lastname: Steger
authors.forename: Rudolf
authors.initials: R
authors.lastname: Steininger
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Mühlbacher
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000494:pharmacology*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D004317:Doxorubicin / Q000494:pharmacology*; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013534:Survival; D013997:Time Factors
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin