Clinical

Liver transplant extends survival in patients with liver cancer

Last Updated: 2003-10-31 13:07:03 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The outcome of liver transplantation in patients with hepatocellular carcinoma (HCC) has improved over the last decade, investigators report in the Journal of Clinical Oncology to be published on December 1. Currently, more than half of these patients survive beyond 5 years.

Using data from the United Network for Organ Sharing database, Dr. Paul J. Thuluvath and associates at Johns Hopkins University Hospital, Baltimore, identified patients who underwent liver transplantation in the US between 1987 and 2001. Included in their analysis were 985 patients whose transplant was to treat HCC, and a control group of more than 33,000 whose transplantation was performed for nonmalignant liver conditions.

Overall 5-year survival was 42.3% for the HCC group and 71.7% in the control group. However, 5-year survival for cancer patients increased steadily over time from 25.3% during 1987 to 1991, to 61.1% during 1997 to 2001.

The authors attribute the reduced mortality over time to careful patient selection based on published criteria.

They note that only about 20% of patients with cirrhosis and HCC are appropriate candidates for liver resection, and that 5-year survival after resection or ethanol injection is only about 30%. Transplantation offers the advantages of complete tumor resection and cure of underlying liver disease.

Dr. Thuluvath and associates conclude that "liver transplantation is the treatment of choice in patients with advanced cirrhosis and HCC."

J Clin Oncol 2003;21.