Recurrence of hepatocellular carcinoma after liver transplantation: Prognostic and predictive factors of survival in a Latin American cohort

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dc.contributor.authorMaccali, Claudia
dc.contributor.authorChagas, Aline L
dc.contributor.authorBoin, Ilka
dc.contributor.authorQuiñonez, Emilio
dc.contributor.authorMarciano, Sebastián
dc.contributor.authorVilatobá, Mario
dc.contributor.authorVarón, Adriana
dc.contributor.authorAnders, Margarita
dc.contributor.authorHoyos Duque, Sergio
dc.contributor.authorLima, Agnaldo S
dc.contributor.authorMenendez, Josemaría
dc.contributor.authorPadilla-Machaca, Martín
dc.contributor.authorPoniachik, Jaime
dc.contributor.authorZapata, Rodrigo
dc.contributor.authorMaraschio, Martín
dc.contributor.authorChong Menéndez, Ricardo
dc.contributor.authorMuñoz, Linda
dc.contributor.authorArufe, Diego
dc.contributor.authorFigueroa, Rodrigo
dc.contributor.authorSoza, Alejandro
dc.contributor.authorFauda, Martín
dc.contributor.authorPerales, Simone R
dc.contributor.authorVergara Sandoval, Rodrigo
dc.contributor.authorBermudez, Carla
dc.contributor.authorBeltran, Oscar
dc.contributor.authorArenas Hoyos, Isabel
dc.contributor.authorMcCormack, Lucas
dc.contributor.authorMattera, Francisco Juan
dc.contributor.authorGadano, Adrián
dc.contributor.authorParente García, Jose H
dc.contributor.authorMegumi Tani, Claudia
dc.contributor.authorCarneiro D'Albuquerque, Luiz Augusto
dc.contributor.authorCarrilho, Flair J
dc.contributor.authorSilva, Marcelo
dc.contributor.authorPiñero, Federico
dc.date.accessioned2021-10-28T12:48:55Z
dc.date.available2021-10-28T12:48:55Z
dc.date.issued2021
dc.description.abstractBackground & aim: Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) has a poor prognosis, and the adjusted effect of different treatments on post-recurrence survival (PRS) has not been well defined. This study aims to evaluate prognostic and predictive variables associated with PRS. Methods: This Latin American multicenter retrospective cohort study included HCC patients who underwent LT between the years 2005-2018. We evaluated the effect of baseline characteristics at time of HCC recurrence diagnosis and PRS (Cox regression analysis). Early recurrences were those occurring within 12 months of LT. To evaluate the adjusted treatment effect for HCC recurrence, a propensity score matching analysis was performed to assess the probability of having received any specific treatment for recurrence. Results: From a total of 1085 transplanted HCC patients, the cumulative incidence of recurrence was 16.6% (CI 13.5-20.3), with median time to recurrence of 13.0 months (IQR 6.0-26.0). Factors independently associated with PRS were early recurrence (47.6%), treatment with sorafenib and surgery/trans-arterial chemoembolization (TACE). Patients who underwent any treatment presented "early recurrences" less frequently, and more extrahepatic metastasis. This unbalanced distribution was included in the propensity score matching, with correct calibration and discrimination (receiving operator curve of 0.81 [CI 0.72;0.88]). After matching, the adjusted effect on PRS for any treatment was HR of 0.2 (0.10;0.33); P < .0001, for sorafenib therapy HR of 0.4 (0.27;0.77); P = .003, and for surgery/TACE HR of 0.4 (0.18;0.78); P = .009. Conclusion: Although early recurrence was associated with worse outcome, even in this population, systemic or locoregional treatments were associated with better PRS.es
dc.identifier.citationLiver International. 2021;41:851–862.es
dc.identifier.urihttps://doi.org/10.1111/liv.14736es
dc.identifier.urihttp://hdl.handle.net/11447/4960
dc.language.isoenes
dc.subjectHepatocellular carcinomaes
dc.subjectLiver transplantationes
dc.subjectPrognosises
dc.subjectRecurrencees
dc.subjectTreatmentes
dc.titleRecurrence of hepatocellular carcinoma after liver transplantation: Prognostic and predictive factors of survival in a Latin American cohortes
dc.typeArticlees

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