No apparent benefit of preemptive sorafenib therapy in liver transplant recipients with advanced hepatocellular carcinoma on explant

Sanjaya Satapathy, Kanak Das, Mehmet Kocak, Ryan A. Helmick, James D. Eason, Satheesh P. Nair, Jason M. Vanatta

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Sorafenib has shown survival benefits in patients with advanced HCC; however, limited data are available on its role in OLT recipients with advanced HCC in the explant. Aim: Evaluate the role of preemptive sorafenib therapy on HCC recurrence and survival after OLT with advanced HCC on explant pathology. Methods: We retrospectively reviewed the outcome after OLT of all HCC recipients with advanced HCC in the explant pathology from 04/2006 to 12/2012 based on preemptive treatment with sorafenib. Results: During the observation period, 217 HCC recipients underwent OLT; 50 explants revealed advanced HCC. After exclusion of 5 patients who were lost to follow-up, 45 LT recipients were finally included for analysis. Recipients were grouped as sorafenib Gr (N = 25) and nonsorafenib Gr (N = 20). Both recurrence-free survival (RFS) (P =.67) and overall survival were similar between groups (P =.53) on Kaplan-Meier analysis. Additionally, sorafenib use was neither associated with HCC recurrence-free survival (HR 0.74, 95% CI [0.32-1.70]; P =.48) nor overall survival (HR 0.92, 95% CI [0.39-2.15], P =.84) on multivariate Cox proportional hazard model with sorafenib use as time-varying covariates. Conclusion: Preemptive treatment with sorafenib in OLT recipients with high-risk features in explant does not improve HCC recurrence-free or overall survival.

Original languageEnglish (US)
Article numbere13246
JournalClinical Transplantation
Volume32
Issue number5
DOIs
StatePublished - May 1 2018

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Hepatocellular Carcinoma
Survival
Liver
Recurrence
Therapeutics
Pathology
Lost to Follow-Up
Kaplan-Meier Estimate
sorafenib
Transplant Recipients
Proportional Hazards Models
Observation

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

No apparent benefit of preemptive sorafenib therapy in liver transplant recipients with advanced hepatocellular carcinoma on explant. / Satapathy, Sanjaya; Das, Kanak; Kocak, Mehmet; Helmick, Ryan A.; Eason, James D.; Nair, Satheesh P.; Vanatta, Jason M.

In: Clinical Transplantation, Vol. 32, No. 5, e13246, 01.05.2018.

Research output: Contribution to journalArticle

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abstract = "Background: Sorafenib has shown survival benefits in patients with advanced HCC; however, limited data are available on its role in OLT recipients with advanced HCC in the explant. Aim: Evaluate the role of preemptive sorafenib therapy on HCC recurrence and survival after OLT with advanced HCC on explant pathology. Methods: We retrospectively reviewed the outcome after OLT of all HCC recipients with advanced HCC in the explant pathology from 04/2006 to 12/2012 based on preemptive treatment with sorafenib. Results: During the observation period, 217 HCC recipients underwent OLT; 50 explants revealed advanced HCC. After exclusion of 5 patients who were lost to follow-up, 45 LT recipients were finally included for analysis. Recipients were grouped as sorafenib Gr (N = 25) and nonsorafenib Gr (N = 20). Both recurrence-free survival (RFS) (P =.67) and overall survival were similar between groups (P =.53) on Kaplan-Meier analysis. Additionally, sorafenib use was neither associated with HCC recurrence-free survival (HR 0.74, 95{\%} CI [0.32-1.70]; P =.48) nor overall survival (HR 0.92, 95{\%} CI [0.39-2.15], P =.84) on multivariate Cox proportional hazard model with sorafenib use as time-varying covariates. Conclusion: Preemptive treatment with sorafenib in OLT recipients with high-risk features in explant does not improve HCC recurrence-free or overall survival.",
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AU - Satapathy, Sanjaya

AU - Das, Kanak

AU - Kocak, Mehmet

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AU - Eason, James D.

AU - Nair, Satheesh P.

AU - Vanatta, Jason M.

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N2 - Background: Sorafenib has shown survival benefits in patients with advanced HCC; however, limited data are available on its role in OLT recipients with advanced HCC in the explant. Aim: Evaluate the role of preemptive sorafenib therapy on HCC recurrence and survival after OLT with advanced HCC on explant pathology. Methods: We retrospectively reviewed the outcome after OLT of all HCC recipients with advanced HCC in the explant pathology from 04/2006 to 12/2012 based on preemptive treatment with sorafenib. Results: During the observation period, 217 HCC recipients underwent OLT; 50 explants revealed advanced HCC. After exclusion of 5 patients who were lost to follow-up, 45 LT recipients were finally included for analysis. Recipients were grouped as sorafenib Gr (N = 25) and nonsorafenib Gr (N = 20). Both recurrence-free survival (RFS) (P =.67) and overall survival were similar between groups (P =.53) on Kaplan-Meier analysis. Additionally, sorafenib use was neither associated with HCC recurrence-free survival (HR 0.74, 95% CI [0.32-1.70]; P =.48) nor overall survival (HR 0.92, 95% CI [0.39-2.15], P =.84) on multivariate Cox proportional hazard model with sorafenib use as time-varying covariates. Conclusion: Preemptive treatment with sorafenib in OLT recipients with high-risk features in explant does not improve HCC recurrence-free or overall survival.

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