학술논문

Number of Local Regional Therapies for Hepatocellular Carcinoma and Peri-Operative Outcomes after Liver Transplantation.
Document Type
Article
Source
Cancers. Feb2023, Vol. 15 Issue 3, p620. 14p.
Subject
*KRUSKAL-Wallis Test
*CONFIDENCE intervals
*SURGICAL complications
*REGRESSION analysis
*RETROSPECTIVE studies
*TREATMENT effectiveness
*POSTOPERATIVE period
*DESCRIPTIVE statistics
*CHI-squared test
*LIVER transplantation
*DATA analysis software
*ODDS ratio
*HEPATOCELLULAR carcinoma
*EVALUATION
Language
ISSN
2072-6694
Abstract
Simple Summary: This was a retrospective single center analysis of 298 consecutive patients with HCC who underwent liver transplant. We sought to understand the impact that the number and type of local regional therapies (LRTs) have on peri-operative outcomes and complications after liver transplantation. The patients who received more than 3 LRTs prior to a liver transplant had a higher risk of biliary leak but otherwise similar outcomes to those who received fewer LRTs. The wait times for patients with hepatocellular carcinoma (HCC) listed for liver transplant are longer than ever, which has led to an increased reliance on the use of pre-operative LRTs. The impact that multiple rounds of LRTs have on peri-operative outcomes following transplant is unknown. This was a retrospective single center analysis of 298 consecutive patients with HCC who underwent liver transplant (January 2017 to May 2021). The data was obtained from two institution-specific databases and the TransQIP database. Of the 298 patients, 27 (9.1%) underwent no LRTs, 156 (52.4%) underwent 1-2 LRTs, and 115 (38.6%) underwent ≥3 LRTs prior to LT. The patients with ≥3 LRTs had a significantly higher rate of bile leak compared to patients who received 1-2 LRTs (7.0 vs. 1.3%, p = 0.014). Unadjusted and adjusted regression analyses demonstrated a significant association between the total number of LRTs administered and bile leak, but not rates of overall biliary complications. The total number of LRTs was not significantly associated with any other peri-operative or post-operative outcome measure. These findings support the aggressive use of LRTs to control HCC in patients awaiting liver transplant, with further evaluation needed to confirm the biliary leak findings. [ABSTRACT FROM AUTHOR]