Prolonged survival after liver transplantation and cancer chemotherapy for advanced-stage hepatocellular carcinoma.

Abstract

Liver transplantation for advanced-stage hepatocellular carcinoma (HCC) has been associated with high tumor recurrence rates, and poor long-term survival.1,2 Cancer chemotherapy for HCC using standard drugs administered intravenously has also been associated with poor survival and negligible response rates.3 However, several recent reports have indicated reproducible response rates involving greater than 50% of patients when various anticancer agents have been administered via the hepatic artery for the treatment of HCC.4,5 We therefore investigated the feasibility of combining both treatment modalities, to determine whether chemotherapy-induced tumor cell destruction prior to surgical manipulation might decrease post-orthotopic liver transplantation (post-OLTx) tumor recurrences and thus enhance survival.