caa a22 4500 445338679 CHVBK 20180317142804.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1803-3 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1803-3 Locoregional Therapy-Induced Tumor Necrosis as a Predictor of Recurrence after Liver Transplant in Patients with Hepatocellular Carcinoma [Elektronische Daten] [Meng-Hsing Ho, Chih-Yung Yu, Kuo-Piao Chung, Teng-Wei Chen, Heng-Cheng Chu, Chih-Kung Lin, Chung-Bao Hsieh] Background: Patients with hepatocellular carcinoma (HCC) often undergo locoregional therapy before liver transplant either to downstage the tumor or as bridge therapy. Our goal was to assess the risk factors for posttransplant tumor recurrence, specifically the extent of necrosis induced by locoregional therapy. Methods: We conducted a hospital-based retrospective analysis of 100 patients with HCC who received a liver transplant, 86 of whom had received pretransplant locoregional therapy. We evaluated various patient- and tumor-related parameters to determine the risk factors for recurrence. Furthermore, we grouped patients by the degree of tumor necrosis after locoregional therapy and identified the factors that were associated with a favorable tumor response. Results: Initial tumor extent beyond the University of San Francisco (UCSF) criteria, microvascular invasion, and attainment of less than 90% tumor necrosis after locoregional therapy were independent risk factors for tumor recurrence. In addition, there was a significant correlation between the tumor necrosis percentage and disease-specific survival rate. Among patients whose tumors initially exceeded the UCSF criteria, those with extensive locoregional therapy-induced tumor necrosis had lower recurrence rates. All recurrences after transplant occurred within 3years, and recurrence rates in patients with extensive tumor necrosis at 1, 2, and 3years were 3%, 6%, and 10%, respectively. Female gender and a solitary tumor were independently associated with extensive tumor necrosis. Conclusions: In HCC patients who are transplant candidates and undergo pretransplant locoregional therapy, the degree of induced tumor necrosis affects both tumor recurrence and survival rate. Society of Surgical Oncology, 2011 Ho Meng-Hsing Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut Yu Chih-Yung Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut Chung Kuo-Piao Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan aut Chen Teng-Wei Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut Chu Heng-Cheng Division of Gastroenterology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut Lin Chih-Kung Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut Hsieh Chung-Bao Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3632-3639 1068-9265 18:13<3632 2011 18 10434 https://doi.org/10.1245/s10434-011-1803-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1803-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ho Meng-Hsing Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut NATIONALLICENCE 700 1- Yu Chih-Yung Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut NATIONALLICENCE 700 1- Chung Kuo-Piao Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan aut NATIONALLICENCE 700 1- Chen Teng-Wei Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut NATIONALLICENCE 700 1- Chu Heng-Cheng Division of Gastroenterology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut NATIONALLICENCE 700 1- Lin Chih-Kung Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut NATIONALLICENCE 700 1- Hsieh Chung-Bao Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3632-3639 1068-9265 18:13<3632 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer