Reuters Health Information (2004-11-01): Chemotherapy before liver transplant may not be necessary
Chemotherapy before liver transplant may not be necessary
Last Updated: 2004-11-01 17:50:13 -0400 (Reuters Health)
BOSTON (Reuters Health) - Locoregional ablative therapy
for hepatocellular carcinoma (HCC) does not appear to improve the
outcome for patients undergoing liver transplantation since
implementation of the current organ allocation system, researchers
announced here at the 55th annual meeting of the American Association
for the Study of Liver Diseases.
Dr. Kim Olthoff, of the University of Pennsylvania in Philadelphia,
presented results of a retrospective study of 74 consecutive patients
with HCC who underwent liver transplantation between February 28, 2002
and February 28, 2004. Thirty-two of these patients underwent
pretransplant locoablative chemotherapy.
The study's time period is important, Dr. Olthoff noted, as the MELD
organ allocation system, in which patients on the transplant waiting
list receive points according to the severity to their disease, was
implemented in 2002.
Waiting time to transplantation was similar for both treated and
untreated patients, as were pathologic and histologic characteristics.
All ablated tumors showed effects of treatment, but there was viable
tumor remaining in 78% of treated explants, Dr. Olthoff said.
Dr. Olthoff reported that 12-month disease-free survival was not
significantly different between treated and untreated patients.
Disease-free survival at one year was 81% in treated patients and 90%
in untreated patients. Overall survival was 87% in ablated patients and
90% in untreated patients.
"This is still a short follow-up period," Dr. Olthoff noted. She
added that in the era of MELD, patients are on the waiting list for an
average of 40 days before receiving liver transplantation.