title: Response to transarterial chemoembolization in candidates with hepatocellular carcinoma within Milan criteria does not predict post-transplant disease-free survival.
abstract: BACKGROUND
  Few groups have studied the impact of pretransplant transarterial chemoembolization (TACE) in the outcomes of liver transplant recipients with hepatocellular carcinoma (HCC). We verified whether response to TACE in HCC candidates impacts post-transplant disease-free survival.
  
  
  METHODS
  This a single center retrospective study of patients who underwent liver transplantation from 2006-2013. Included were those transplanted due to HCC within the Milan criteria who were treated with TACE in the pre-transplant period. Response to TACE followed the modified RECIST (mRECIST) criteria. Disease free-survival was the main endpoint of the study.
  
  
  RESULTS
  We included 187 patients in this study. The population had an average age of 57.5 years, predominantly formed by men (82.5%), with an average IMC of 26.7, MELD of 13, with viral hepatitis as main cause of liver disease. Average waiting time was 253 days and follow-up was 27.3 months. Based on response to TACE, 3-year disease-free survival was 84.1% for those with complete response to TACE, 84.1% for those with partial response to TACE, 85.7% for those with stable disease and 100% for patients with progressive disease. Multivariate analysis did not identify response to TACE as a predictor of disease-free post-transplant survival.
  
  
  CONCLUSIONS
  Response to TACE in candidates with HCC within Milan criteria does not predict post-transplant disease-free survival.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: salvalaggio@einstein.br.
authors.forename: P R
authors.initials: PR
authors.lastname: Salvalaggio
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: G E
authors.initials: GE
authors.lastname: Felga
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: J A
authors.initials: JA
authors.lastname: Alves
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: R F
authors.initials: RF
authors.lastname: Meirelles
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: M D
authors.initials: MD
authors.lastname: Almeida
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: M B
authors.initials: MB
authors.lastname: de Rezende
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D018572:Disease-Free Survival; D004998:Ethiodized Oil / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D004998:Ethiodized Oil