title: Liver Transplantation After Transarterial Chemoembolization and Radiotherapy for Hepatocellular Carcinoma with Vascular Invasion.
abstract: The study aims to analyze the oncologic outcomes of living donor liver transplantation (LDLT) after combined transarterial chemoembolization (TACE) and radiotherapy for hepatocellular carcinoma (HCC) with major vascular invasion.
  
  
  
  We retrospectively reviewed 17 HCC patients with major vascular invasion who underwent LDLT after combined treatment modality between May 2007 and September 2014. The LDLT timing was determined by the surgeons depending on the disease status and liver function. The intrahepatic recurrence-free survival, disease-free survival (DFS), and overall survival (OS) rates were estimated from the date of the LDLT.
  
  
  
  The median follow-up period was 24.5 months (range, 6.4-66.0 months) after the LDLT. The interval between the combined treatment and the LDLT was a median of 5 months (range, 0.4-65.3 months). On the explanted liver, total necrosis was shown in five patients (29.4 %). The 1- and 3-year DFS rates were 70.6 and 57.8 %, respectively. The 1- and 3-year OS rates were 87.4 and 60.5 %, respectively. The major pattern of failure was distant metastasis (35.3 %), and intrahepatic recurrence occurred in three patients (17.6 %) who experienced distant metastasis.
  
  
  
  In the selected HCC patients with major vascular invasion, LDLT after combined TACE and radiotherapy showed acceptable oncologic outcomes.
authors: Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
authors: Yuri
authors: Y
authors: Jeong
authors: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
authors: Min-Ho
authors: MH
authors: Shin
authors: Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. drsmyoon@amc.seoul.kr.
authors: Sang Min
authors: 0000-0002-5138-3051
authors: SM
authors: Yoon
authors: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. drsong71@amc.seoul.kr.
authors: Gi-Won
authors: GW
authors: Song
authors: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
authors: Ki-Hun
authors: KH
authors: Kim
authors: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
authors: Chul-Soo
authors: CS
authors: Ahn
authors: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
authors: Deok-Bog
authors: DB
authors: Moon
authors: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
authors: Shin
authors: S
authors: Hwang
authors: Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
authors: Jin-Hong
authors: JH
authors: Park
authors: Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
authors: Jong Hoon
authors: JH
authors: Kim
authors: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
authors: Sung-Gyu
authors: SG
authors: Lee
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery* / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery* / Q000628:therapy; D016031:Liver Transplantation / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary / Q000628:therapy*
keywords: Hepatocellular carcinoma; Living donor liver transplantation; Radiotherapy; Transarterial chemoembolization; Vascular invasion