Adjuvant adenovirus-mediated delivery of herpes simplex virus thymidine kinase administration improves outcome of liver transplantation in patients with advanced hepatocellular carcinoma.
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.
Li
Ning
N
Beijing YouAn Hospital, Capital Medical University, China.
Zhou
Jianfeng
J
Weng
Danhui
D
Zhang
Chenghua
C
Li
Lixin
L
Wang
Beibei
B
Song
Yang
Y
He
Qiang
Q
Lin
Dongdong
D
Chen
Dazhi
D
Chen
Gang
G
Gao
Qinglei
Q
Wang
Shixuan
S
Xu
Gang
G
Meng
Li
L
Lu
Yunping
Y
Ma
Ding
D
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
D013937:Thymidine Kinase