Clinical Edge Journal Scan

Liver Transplant for HCC: Long-term outcome of downstaging to within Milan criteria support national downstaging policy


Key clinical point: The excellent 10-year post-liver transplant (LT) outcomes in patients with hepatocellular carcinoma (HCC) successfully downstaged to within Milan criteria (MC) substantiate the validity of the national downstaging policy.

Major finding: At 10 years after LT, patients with HCC always within MC, those with HCC downstaged before LT, and those with HCC unsuccessfully downstaged/progressed beyond MC during LT had survival rates of 61.5%, 52.1%, and 43.3%, respectively, and recurrence rates of 13.3%, 20.6%, and 41.4%, respectively.

Study details: This retrospective cohort study analyzed the prospective data of 2645 adult patients with HCC who underwent LT at 5 US academic centers.

Disclosures: This study was sponsored by the US Department of Defense, Samuel Waxman Cancer Research Foundation, Spanish National Health Institute, and Cancer Research UK, among others. Two authors reported receiving grants or a board of directors’ honoraria from various sources.

Source: Tabrizian P et al. Ten-year outcomes of liver transplant and downstaging for hepatocellular carcinoma. JAMA Surg. 2022 (Jul 20). Doi: 10.1001/jamasurg.2022.2800

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