title: Impact of transarterial therapy in hepatitis C-related hepatocellular carcinoma on long-term outcomes after liver transplantation.
abstract: OBJECTIVE
  To evaluate the impact of long-term outcomes of transarterial embolization (TAE) therapy in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) on the waiting list for liver transplantation (LT).
  
  
  METHODS
  We retrospectively evaluated the post-LT patients with HCV-related HCC who received TAE intervention (n=33) and those who had no treatment (n=47) while on the waiting list to determine long-term outcomes.
  
  
  RESULTS
  Over a 10-year period, of the 424 patients transplanted with HCV, 80 patients had HCC with a tumor burden within Milan criteria. For the entire study cohort, the mean duration of post-LT follow-up was 3.5 years; mean time of transplant waiting list was 120 days; and median post-LT survival was 8.9 years. The survival rates at 1, 3, 5, and 10 years were 82%, 70%, 55%, and 35%, respectively. From the study cohort, 33 patients received TAE and 47 patients did not while on the waiting list. The 2 groups were well matched, except, that the intervention patients received post-LT interferon more often and had a shorter time on the waiting list (56.2 d) when compared with the no treatment group (164.6 d, P<0.001). Median survival in the TAE group was 4.8 years and 8.9 years in the no treatment group. The recurrence rate was 15.6% in the treatment group and 6.9% in the no therapy group (P=0.275).
  
  
  CONCLUSIONS
  Pre-LT transarterial therapy has no benefit on post-LT survival and tumor recurrence in patients with HCV-related HCC who underwent a mean waiting period of <3 months to transplant.
authors.affiliation: Department of Medicine, Division of Gastroenterology, Hepatology Section of Hepatobiliary Diseases and Liver Transplantation, University of Florida, Gainesville, USA. cabrer@medicine.ufl.edu
authors.forename: Roniel
authors.initials: R
authors.lastname: Cabrera
authors.forename: Renumathy
authors.initials: R
authors.lastname: Dhanasekaran
authors.forename: James
authors.initials: J
authors.lastname: Caridi
authors.forename: Virgina
authors.initials: V
authors.lastname: Clark
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morelli
authors.forename: Consuelo
authors.initials: C
authors.lastname: Soldevila-Pico
authors.forename: Joseph
authors.initials: J
authors.lastname: Magglioca
authors.forename: David
authors.initials: D
authors.lastname: Nelson
authors.forename: Roberto Jose
authors.initials: RJ
authors.lastname: Firpi
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D016174:Hepacivirus / Q000472:pathogenicity; D006526:Hepatitis C / Q000150:complications / Q000401:mortality / Q000821:virology*; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014850:Waiting Lists