METHODS: Retrospective data were collected from four transplant centers from Germany and Austria. We included patients with HCC recurrence after LT between 2007 and 2020 who were treated with a TKI.
RESULTS: In total, we analyzed data from 46 patients with HCC recurrence after LT. The most common underlying liver disease was hepatitis C, accounting for 52.2%. The median time to relapse was 11.8 months (range 0-117.7 months). The liver graft was affected in 21 patients (45.7%), and 36 patients (78.3%) had extrahepatic metastases at initial diagnosis of recurrence, with the lung being the most commonly affected (n = 25, 54.3%). Of the total, 54.3% (n = 25) of the patients were initially treated locally; 39 (85.8%) and 7 (15.2%) patients received sorafenib and lenvatinib, respectively, as first-line systemic therapy. Median overall survival of the whole cohort was 10.9 months (95% confidence interval (95% CI) 6.9-14.9 months) and median progression free survival was 5.7 months (95% CI 2.0-9.4 months) from treatment initiation.
CONCLUSIONS: Since history of liver transplantation is considered a contraindication for immunotherapy, prognosis of patients with HCC recurrence after LT remains poor.
方法:回顾性数据来自德国和奥地利的四个移植中心。我们纳入了2007年至2020年间接受TKI治疗的LT术后HCC复发患者。
结果:总计,我们分析了46例肝移植后HCC复发患者的数据。最常见的潜在肝病是丙型肝炎,占52.2%。中位复发时间为11.8个月(0-117.7个月)。21例患者(45.7%)肝脏移植受累,36例(78.3%)在初次诊断复发时发生肝外转移,与肺是最常见的影响(n=25,54.3%)。在总数中,54.3%(n=25)的患者最初接受了局部治疗;39例(85.8%)和7例(15.2%)患者接受了索拉非尼和乐伐替尼,分别,作为一线全身治疗。整个队列的中位总生存期为10.9个月(95%置信区间(95%CI)6.9-14.9个月),中位无进展生存期为5.7个月(95%CI2.0-9.4个月)。
结论:由于肝移植史被认为是免疫治疗的禁忌症,肝移植后HCC复发患者的预后仍然很差。