Tumor Burden Limits Liver Transplant Feasibility for HCC

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Researchers have uncovered an upper limit in tumor burden after which there is a lower probability of successfully downstaging patients with hepatocellular carcinoma (HCC) for liver transplantation, according to findings presented at the 2016 AASLD Liver Meeting.

In the small prospective study, tumor burden was negatively predictive of successful downstaging for patients with HCC (HR, 0.87; P <.05). Overall, patients with a sum of number of tumors plus largest tumor diameter of 8 had a 68% probability of being downstaged to within Milan criteria at 1 year compared to those with a tumor burden of 14 who had only a 38% probability at 1 year.

“Using this metric of tumor burden, the sum of the number of lesions plus the diameter of the largest tumor, we can see that the greater the tumor burden, the lower the rate of successful downstaging,” said lead investigator Jasmine Rassiwala, MD, MPH, from the University of California, San Francisco (UCSF). “Our results suggest that there does exist an upper limit in tumor burden beyond which successful downstaging to a goal of liver transplant becomes unrealistic.”

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