Non-resective ablation and liver transplantation in patients with cirrhosis and hepatocellular carcinoma (HCC)

Safety and efficacy

Daniel Maluf, Robert A. Fisher, T. Maroney, A. Cotterell, A. Fulcher, J. Tisnado, M. Contos, V. Luketic, R. Stravitz, M. Shiffman, R. Sterling, M. Posner

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

We investigated the efficacy of nonresective ablation techniques and the tumor-free survival of cirrhotic patients undergoing liver transplantation for hepatocellular carcinoma (HCC). In group 1, 11 HCC patients were treated with these techniques and transplanted. On the waiting list, patients were treated to complete ablation, judged by gadolinium-enhanced MRI and alpha-fetoprotein (AFP) levels. Group 1 was compared with a concurrent group of 10 liver transplant patients (group 2) with incidental HCC (stages T1 = three patients, T2 = seven patients). The group 1 patients received 36 procedures (4 alcohol ablations, 14 transhepatic artery chemo-embolizations, 15 trans-hepatic chemo-infusions, and 3 radio frequency ablations) for treatment of 13 liver masses. Tumor-node-metastasis (TNM) stage was reduced in eight patients (72.7%), unchanged in two patients and increased in one patient before transplantation. The mean waiting time for transplantation was 12.9 ± 7.6 months. Both groups had a tumor-free survival of 100%, at 30 ± 12 months post transplant. On pathology, 54.5% of explanted livers had residual viable HCC after tumor treatment, and 36.4% (4/11) explants had synchronous lesions. Non-resective ablation therapy is safe and effective in reducing the HCC progression in cirrhotic patients awaiting liver transplantation. The cancer-free survival rate in this treatment group is equal to that for incidental T1-T2 HCCs.

Original languageEnglish (US)
Pages (from-to)312-317
Number of pages6
JournalAmerican Journal of Transplantation
Volume3
Issue number3
DOIs
StatePublished - Mar 1 2003

Fingerprint

Liver Transplantation
Hepatocellular Carcinoma
Fibrosis
Safety
Liver
Neoplasms
Transplantation
Ablation Techniques
Transplants
Waiting Lists
Survival
Gadolinium
alpha-Fetoproteins
Therapeutics
Radio
Survival Rate
Arteries
Alcohols
Pathology
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Non-resective ablation and liver transplantation in patients with cirrhosis and hepatocellular carcinoma (HCC) : Safety and efficacy. / Maluf, Daniel; Fisher, Robert A.; Maroney, T.; Cotterell, A.; Fulcher, A.; Tisnado, J.; Contos, M.; Luketic, V.; Stravitz, R.; Shiffman, M.; Sterling, R.; Posner, M.

In: American Journal of Transplantation, Vol. 3, No. 3, 01.03.2003, p. 312-317.

Research output: Contribution to journalArticle

Maluf, D, Fisher, RA, Maroney, T, Cotterell, A, Fulcher, A, Tisnado, J, Contos, M, Luketic, V, Stravitz, R, Shiffman, M, Sterling, R & Posner, M 2003, 'Non-resective ablation and liver transplantation in patients with cirrhosis and hepatocellular carcinoma (HCC): Safety and efficacy', American Journal of Transplantation, vol. 3, no. 3, pp. 312-317. https://doi.org/10.1034/j.1600-6143.2003.00041.x
Maluf, Daniel ; Fisher, Robert A. ; Maroney, T. ; Cotterell, A. ; Fulcher, A. ; Tisnado, J. ; Contos, M. ; Luketic, V. ; Stravitz, R. ; Shiffman, M. ; Sterling, R. ; Posner, M. / Non-resective ablation and liver transplantation in patients with cirrhosis and hepatocellular carcinoma (HCC) : Safety and efficacy. In: American Journal of Transplantation. 2003 ; Vol. 3, No. 3. pp. 312-317.
@article{15f80d9cc1c14b0a9bfe8f6604caae89,
title = "Non-resective ablation and liver transplantation in patients with cirrhosis and hepatocellular carcinoma (HCC): Safety and efficacy",
abstract = "We investigated the efficacy of nonresective ablation techniques and the tumor-free survival of cirrhotic patients undergoing liver transplantation for hepatocellular carcinoma (HCC). In group 1, 11 HCC patients were treated with these techniques and transplanted. On the waiting list, patients were treated to complete ablation, judged by gadolinium-enhanced MRI and alpha-fetoprotein (AFP) levels. Group 1 was compared with a concurrent group of 10 liver transplant patients (group 2) with incidental HCC (stages T1 = three patients, T2 = seven patients). The group 1 patients received 36 procedures (4 alcohol ablations, 14 transhepatic artery chemo-embolizations, 15 trans-hepatic chemo-infusions, and 3 radio frequency ablations) for treatment of 13 liver masses. Tumor-node-metastasis (TNM) stage was reduced in eight patients (72.7{\%}), unchanged in two patients and increased in one patient before transplantation. The mean waiting time for transplantation was 12.9 ± 7.6 months. Both groups had a tumor-free survival of 100{\%}, at 30 ± 12 months post transplant. On pathology, 54.5{\%} of explanted livers had residual viable HCC after tumor treatment, and 36.4{\%} (4/11) explants had synchronous lesions. Non-resective ablation therapy is safe and effective in reducing the HCC progression in cirrhotic patients awaiting liver transplantation. The cancer-free survival rate in this treatment group is equal to that for incidental T1-T2 HCCs.",
author = "Daniel Maluf and Fisher, {Robert A.} and T. Maroney and A. Cotterell and A. Fulcher and J. Tisnado and M. Contos and V. Luketic and R. Stravitz and M. Shiffman and R. Sterling and M. Posner",
year = "2003",
month = "3",
day = "1",
doi = "10.1034/j.1600-6143.2003.00041.x",
language = "English (US)",
volume = "3",
pages = "312--317",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Non-resective ablation and liver transplantation in patients with cirrhosis and hepatocellular carcinoma (HCC)

T2 - Safety and efficacy

AU - Maluf, Daniel

AU - Fisher, Robert A.

AU - Maroney, T.

AU - Cotterell, A.

AU - Fulcher, A.

AU - Tisnado, J.

AU - Contos, M.

AU - Luketic, V.

AU - Stravitz, R.

AU - Shiffman, M.

AU - Sterling, R.

AU - Posner, M.

PY - 2003/3/1

Y1 - 2003/3/1

N2 - We investigated the efficacy of nonresective ablation techniques and the tumor-free survival of cirrhotic patients undergoing liver transplantation for hepatocellular carcinoma (HCC). In group 1, 11 HCC patients were treated with these techniques and transplanted. On the waiting list, patients were treated to complete ablation, judged by gadolinium-enhanced MRI and alpha-fetoprotein (AFP) levels. Group 1 was compared with a concurrent group of 10 liver transplant patients (group 2) with incidental HCC (stages T1 = three patients, T2 = seven patients). The group 1 patients received 36 procedures (4 alcohol ablations, 14 transhepatic artery chemo-embolizations, 15 trans-hepatic chemo-infusions, and 3 radio frequency ablations) for treatment of 13 liver masses. Tumor-node-metastasis (TNM) stage was reduced in eight patients (72.7%), unchanged in two patients and increased in one patient before transplantation. The mean waiting time for transplantation was 12.9 ± 7.6 months. Both groups had a tumor-free survival of 100%, at 30 ± 12 months post transplant. On pathology, 54.5% of explanted livers had residual viable HCC after tumor treatment, and 36.4% (4/11) explants had synchronous lesions. Non-resective ablation therapy is safe and effective in reducing the HCC progression in cirrhotic patients awaiting liver transplantation. The cancer-free survival rate in this treatment group is equal to that for incidental T1-T2 HCCs.

AB - We investigated the efficacy of nonresective ablation techniques and the tumor-free survival of cirrhotic patients undergoing liver transplantation for hepatocellular carcinoma (HCC). In group 1, 11 HCC patients were treated with these techniques and transplanted. On the waiting list, patients were treated to complete ablation, judged by gadolinium-enhanced MRI and alpha-fetoprotein (AFP) levels. Group 1 was compared with a concurrent group of 10 liver transplant patients (group 2) with incidental HCC (stages T1 = three patients, T2 = seven patients). The group 1 patients received 36 procedures (4 alcohol ablations, 14 transhepatic artery chemo-embolizations, 15 trans-hepatic chemo-infusions, and 3 radio frequency ablations) for treatment of 13 liver masses. Tumor-node-metastasis (TNM) stage was reduced in eight patients (72.7%), unchanged in two patients and increased in one patient before transplantation. The mean waiting time for transplantation was 12.9 ± 7.6 months. Both groups had a tumor-free survival of 100%, at 30 ± 12 months post transplant. On pathology, 54.5% of explanted livers had residual viable HCC after tumor treatment, and 36.4% (4/11) explants had synchronous lesions. Non-resective ablation therapy is safe and effective in reducing the HCC progression in cirrhotic patients awaiting liver transplantation. The cancer-free survival rate in this treatment group is equal to that for incidental T1-T2 HCCs.

UR - http://www.scopus.com/inward/record.url?scp=0037355157&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037355157&partnerID=8YFLogxK

U2 - 10.1034/j.1600-6143.2003.00041.x

DO - 10.1034/j.1600-6143.2003.00041.x

M3 - Article

VL - 3

SP - 312

EP - 317

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 3

ER -