Clinical and laboratory parameters as predictors of long-term outcome according to the etiology of underlying chronic liver disease in patients who underwent liver transplantation for hepatocellular carcinoma treatment

• Autor(a) principal: Paulo Henrique Costa Diniz
• Data de Publicação: 2020
• Outros Autores: Serena Dafne do Carmo Silva, Luciana Costa Faria, Paula Vieira Teixeira Vidigal, Teresa Cristina de Abreu Ferrari
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.6061/clinics/2020/e1529; http://hdl.handle.net/1843/56596; https://orcid.org/0000-0003-2016-5593; https://orcid.org/0000-0002-6705-0323; https://orcid.org/0000-0002-0226-3491; https://orcid.org/0000-0002-7003-5159; https://orcid.org/0000-0001-9459-2294
• topic: Hepatocellular carcinoma; Liver transplantation; Liver cirrhosis; Recurrence; Carcinoma hepatocelular; Transplante de fígado; Cirrose hepática; Recidiva; Doença hepática terminal

Objectives: This study aimed to analyze clinical and laboratory parameters and their association with long-term outcomes in patients who underwent liver transplantation for hepatocellular carcinoma treatment, according to the etiology of the underlying chronic liver disease, in order to identify predictors of response to this therapeutic modality. Methods: Demographic, clinical, and laboratory data from a cohort of 134 patients who underwent orthotopic liver transplantation for hepatocellular carcinoma treatment at a referral center in Brazil were retrospectively selected and compared according to the etiologic group of the underlying chronic liver disease. Events, defined as tumor recurrence or death from any cause, and event-free survival were also analyzed, and multivariate analysis was performed. Results: The etiologies comprised hepatitis C and B virus infection, alcohol abuse, and cryptogenic disorder. Although liver transplantation was performed outside the Milan criteria in 33.3% of the subjects, according topathologic examination of the explanted liver, the Model for End-Stage Liver Disease score was low (o22) in most patients (70.6%) and recurrence was identified in only 10 (7.9%) patients. Events occurred in 37 patients(28.5%), and the median event-free survival was 75 months (range, 24-116 months). No difference amongetiologic groups was found in the parameters analyzed, which were not independently associated withoutcome. Conclusion: Clinical and laboratory characteristics according to etiologic groups were not different, which might have led to comparable long-term outcomes among these patient groups and failure to identify predictors that could aid in better selection of subjects for liver transplantation in the management of this cancer.