Adjuvant chemotherapy improves survival after liver transplantation for hepatocellular carcinoma

Kim M. Olthoff, Michael H. Rosove, Christopher R. Shackleton, David K. Imagawa, Douglas G. Farmer, Petronella Northcross, Anita L. Pakrasi, Paul Martin, Leonard I. Goldstein, Abraham Shaked, Ronald W. Busuttil

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144 Scopus citations

Abstract

Objective: The aim of this study was to evaluate the effect of postoperative adjuvant chemotherapy on the recurrence rate and survival of patients after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC). Summary Background Data: Historically, liver transplantation for HCC has yielded poor long term survival. Multimodality therapy has been initiated in an effort to improve survival statistics. Methods: Twenty-five patients were placed on 6 months of intravenous fluorouracil, doxorubicin, and cisplatin after OLT. Risk factors, recurrence rates, and survival rates were analyzed and compared with historic controls. Results: Overall long- term survival in the protocol patients was 46% at 3 years, improved over our historic controls of 5.8% at 3 years (p = 0.0001). Overall recurrence rate was 20% (n = 4). Possible risk factors, such as tumor size, vascular invasion, multilocality, capsular invasion, and tumor differentiation, were not found to be significantly predictive of survival. Three patients with long term, disease free survival had tumors > 5 cm. Side effects from chemotherapy were common, but rarely severe. Conclusions: This study suggests that adjuvant chemotherapy after transplantation for HCC can provide long term cure and may improve survival, even in patients with stage III and IV disease.

Original languageEnglish (US)
Pages (from-to)734-743
Number of pages10
JournalAnnals of surgery
Volume221
Issue number6
DOIs
StatePublished - Jun 1995
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Olthoff, K. M., Rosove, M. H., Shackleton, C. R., Imagawa, D. K., Farmer, D. G., Northcross, P., Pakrasi, A. L., Martin, P., Goldstein, L. I., Shaked, A., & Busuttil, R. W. (1995). Adjuvant chemotherapy improves survival after liver transplantation for hepatocellular carcinoma. Annals of surgery, 221(6), 734-743. https://doi.org/10.1097/00000658-199506000-00012