title: Adjuvant adenovirus-mediated delivery of herpes simplex virus thymidine kinase administration improves outcome of liver transplantation in patients with advanced hepatocellular carcinoma.
abstract: OBJECTIVE
  Previous poor results of liver transplantation (LT) have been confirmed in patients with advanced hepatocellular carcinoma (HCC). Adenovirus-mediated delivery of herpes simplex virus thymidine kinase (ADV-TK) therapy is an established adjuvant treatment in cancer, and we evaluated its potential as an adjuvant treatment for HCC patients who underwent LT.
  
  
  METHODS
  Forty-five HCC patients with tumors >5 cm in diameter participated in the study over a follow-up period of 50 months. Among these patients, 22 received LT only, and 23 received LT combined with ADV-TK therapy. All HCC patients enrolled in this study had tumors >5 cm in diameter and no metastasis in lungs or bones was detected by computed tomography or magnetic resonance imaging scans.
  
  
  RESULTS
  The recurrence-free survival and the overall survival in the LT plus ADV-TK therapy group were 43.5% and 69.6%, respectively, at 3 years; both values were significantly higher than those in the LT-only group (9.1% and 19.9%, respectively). In the nonvascular invasion subgroup, overall survival was 100% and recurrence-free survival was 83.3% in the patients receiving LT plus ADV-TK, significantly higher than the patients receiving LT only.
  
  
  CONCLUSIONS
  HCC patients with no vascular invasion could be selected for LT followed by adjuvant ADV-TK therapy, regardless of intrahepatic huge or diffuse tumor. We propose that the current criteria for LT based on tumor size may be expanded if accompanied by ADV-TK therapy due to improved prognosis.
authors.affiliation: Beijing YouAn Hospital, Capital Medical University, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Zhou
authors.forename: Danhui
authors.initials: D
authors.lastname: Weng
authors.forename: Chenghua
authors.initials: C
authors.lastname: Zhang
authors.forename: Lixin
authors.initials: L
authors.lastname: Li
authors.forename: Beibei
authors.initials: B
authors.lastname: Wang
authors.forename: Yang
authors.initials: Y
authors.lastname: Song
authors.forename: Qiang
authors.initials: Q
authors.lastname: He
authors.forename: Dongdong
authors.initials: D
authors.lastname: Lin
authors.forename: Dazhi
authors.initials: D
authors.lastname: Chen
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.forename: Qinglei
authors.initials: Q
authors.lastname: Gao
authors.forename: Shixuan
authors.initials: S
authors.lastname: Wang
authors.forename: Gang
authors.initials: G
authors.lastname: Xu
authors.forename: Li
authors.initials: L
authors.lastname: Meng
authors.forename: Yunping
authors.initials: Y
authors.lastname: Lu
authors.forename: Ding
authors.initials: D
authors.lastname: Ma
mesh_terms: D000256:Adenoviridae / Q000235:genetics*; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D018014:Gene Transfer Techniques; D015316:Genetic Therapy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000235:genetics*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018139:Simplexvirus / Q000201:enzymology*; D013937:Thymidine Kinase / Q000235:genetics*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D013937:Thymidine Kinase