Sorafenib for recurrent hepatocellular carcinoma after liver transplantation: a South American experience

FEDERICO PIÑERO; SEBASTIÁN MARCIANO; MARGARITA ANDERS; FEDERICO OROZCO GANEM; ALINA ZEREGA; JOSEMARÍA MENÉNDEZ; MANUEL MENDIZÁBAL; MATÍAS TISI BAÑA; OCTAVIO GIL,; SOLANGE GERONA; EDUARDO DE SANTIBAÑES; RICARDO MASTAI; ADRIÁN GADANO; MARCELO SILVA

Acta Gastroenterol Latinoam

Acta Gastroenterol Latinoam

Año: 2017

2469-1119

Recurrent hepatocellular carcinoma (HCC) after liver transplantation (LT) has been related with dismal prognosis. The aim of this study was to describe the treatments performed after HCC recurrence in 2 Latin-American countries, and to identify significant factors related to post progression survival. Methods. From 803 adult transplanted patients in 5 LT centers from Argentina and Uruguay (2005-2011), patients with HCC recurrence were included. ?Early recurrence? was considered when it occurred during the first year after transplantation. Patients were analyzed according to the treatment introduced after recurrence diagnosis. The post progression survival was compared. Results. Recurrence presented in 20 out of 135 patients (14.8%), 11 (55%) had early recurrences. After recurrence, 14 patients had good performance status and 18 were Child Pugh A. Ten patients received best supportive care (BSC), 10 patients sorafenib, 1 patient local radiotherapy and 1 patient loco regional surgery. Patients with sorafenib had prolonged post progression survival compared to BSC (5.0 months vs 3.0 months; p = 0.04). On multivariate Cox regression analysis, early recurrence was the only factor related to worst survival, hazard ratio = 3.8 (p = 0.01). A survival benefit with sorafenib in patients with late recurrence when compared to early recurrence was observed (16.0 vs 3.0 months, respectively; p = 0.027). Conclusion. although efficacy of Sorafenib for recurrent HCC should be evaluated in a much-needed randomized controlled trial, a time-selection criterion for this treatment should also be assessed.