Page 246 - ebook HCC

EASL HCC SUMMITHCC SUMMIT
PROGRAMME AND ABSTRACTSAND ABSTRACTS
GENEVA, SWITZERLANDA, SWITZERLAND
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244 PROGRAMME GENEV EASL 245
FEBRUAR
FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
Poster Board Number C31
MAXIMUM ONCOLOGICAL EFFECT INDUCED
BY NEOADJUVANT TRANSARTERIAL CATHETER
EMBOLIZATION HAS NO IMPACT ON DISEASE-
FREE SURVIVAL OF LIVER TRANSPLANT
RECIPIENTS WITH A SINGLE HEPATOCELLULAR
CARCINOMA WITHIN THE MILAN CRITERIA

Guilherme Felga , Paolo Salvalaggio , Lidiane V. Marins , Independent predictors of complete response according to mRECIST associated with
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Bianca Della-Guardia , Marcelo Bruno Rezende , Marcio Dias Almeida 1 extensive necrosis (>=70%) were encapsulated lesions (OR 10.0 CI95% 1.08-92.2,
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1 Liver Transplantation Unit, Department of pathology, Hospital Israelita Albert Einstein, p 0.042), and MELD score (OR 1.28 CI95% 1.01-1.63). Post-LT recurrence rates (A 0%
São Paulo, Brazil vs. B 11.8%, p 0.238), and DFS were similar (A 1, 3 and 5 years 100% vs. B 1 year
91%, 3 and 5 years 87%, p 0.259). Multivariate analysis using a Cox proportional hazards
Corresponding author’s e-mail: gfelga@einstein.br model confirmed that complete response associated with extensive necrosis was a poor
independent predictor of DFS (HR 1.0 CI95% 0.0-3.3, p 0.837).
Introduction: Transarterial catheter embolization (TACE) is the most used method Conclusions: TACE as neoadjuvant treatment of HCC for patients with a single HCC
for neoadjuvant treatment of liver transplantation (LT) candidates with hepatocellular nodule within the Milan criteria waiting LT is incapable of modifying clinically significant
carcinoma (HCC) within the Milan criteria. Nevertheless, its impact on post-operative oncological outcomes despite radiological response and extensive pathological necrosis.
recurrence is controversial. The objective of maximum oncological effect of TACE before LT is not relevant to post-
LT outcomes, and may guide LT teams towards a more balanced use of this therapeutic
Aims: To evaluate whether maximum oncological effect, defined complete response resource.
according to modified Response Evaluation Criteria In Solid Tumors (mRECIST) and
extensive necrosis (>=70%) of the HCC nodule on pathological examination, resulted in
distinct disease-free survival (DFS).
CLINICAL POSTER ABSTRACTS the Milan criteria according to preoperative imaging who underwent neoadjuvant TACE CLINICAL POSTER ABSTRACTS
Methodology: Retrospective review of adult LT recipients with a single HCC nodule within
from July, 2006 through October, 2013. Patients with maximum oncological effect (group
A) were compared to those without these characteristics (group B).
Results: Group A had 14 patients, group B had 34 patients. Similar demographic,
laboratorial, radiological, and pathological data were observed. Group A presented with
more severe liver dysfunction at LT, defined by higher Child-Pugh (7.5±1.7 vs. 6.5±1.2,
p 0.02), and MELD (15.8±7.5 vs. 11.1±3.0, p 0.04) scores. On pathological examination,
the frequency of encapsulated lesions was significantly higher in group A (92.9% vs.
52.9%, p 0.009).