肝移植受者肝移植时肿瘤进展，索拉非尼预先治疗无明显获益。
No apparent benefit of preemptive sorafenib therapy in liver transplant recipients with advanced hepatocellular carcinoma on explant.
机构信息
Transplantation, Methodist University Hospital Transplant Institute/University of Tennessee Health Sciences Center, Memphis, TN, USA.
Division of Gastroenterology, University of Tennessee Health Sciences Center, Memphis, TN, USA.
出版信息
Clin Transplant. 2018 May;32(5):e13246. doi: 10.1111/ctr.13246. Epub 2018 Apr 19.
BACKGROUND
Sorafenib has shown survival benefits in patients with advanced HCC; however, limited data are available on its role in OLT recipients with advanced HCC in the explant.
AIM
Evaluate the role of preemptive sorafenib therapy on HCC recurrence and survival after OLT with advanced HCC on explant pathology.
METHODS
We retrospectively reviewed the outcome after OLT of all HCC recipients with advanced HCC in the explant pathology from 04/2006 to 12/2012 based on preemptive treatment with sorafenib.
RESULTS
During the observation period, 217 HCC recipients underwent OLT; 50 explants revealed advanced HCC. After exclusion of 5 patients who were lost to follow-up, 45 LT recipients were finally included for analysis. Recipients were grouped as sorafenib Gr (N = 25) and nonsorafenib Gr (N = 20). Both recurrence-free survival (RFS) (P = .67) and overall survival were similar between groups (P = .53) on Kaplan-Meier analysis. Additionally, sorafenib use was neither associated with HCC recurrence-free survival (HR 0.74, 95% CI [0.32-1.70]; P = .48) nor overall survival (HR 0.92, 95% CI [0.39-2.15], P = .84) on multivariate Cox proportional hazard model with sorafenib use as time-varying covariates.
CONCLUSION
Preemptive treatment with sorafenib in OLT recipients with high-risk features in explant does not improve HCC recurrence-free or overall survival.
背景
索拉非尼已显示出对晚期 HCC 患者的生存益处；然而，在切除的组织中，关于其在晚期 HCC 的 OLT 受者中的作用的数据有限。
目的
评估在切除的组织中存在晚期 HCC 时，预先使用索拉非尼治疗对 OLT 后 HCC 复发和生存的作用。
方法
我们回顾性地研究了 2006 年 4 月至 2012 年 12 月期间所有在切除的组织中存在晚期 HCC 的 HCC 接受者 OLT 后的结果，这些患者接受了预先使用索拉非尼治疗。
结果
在观察期间，有 217 例 HCC 接受者接受了 OLT；50 个切除的组织显示存在晚期 HCC。排除 5 例失访患者后，最终有 45 例 LT 接受者被纳入分析。将接受者分为索拉非尼组（N=25）和非索拉非尼组（N=20）。Kaplan-Meier 分析显示，两组的无复发生存率（RFS）（P=0.67）和总生存率（P=0.53）相似。此外，在多变量 Cox 比例风险模型中，索拉非尼的使用与 HCC 无复发生存（HR 0.74，95%CI [0.32-1.70]；P=0.48）或总生存率（HR 0.92，95%CI [0.39-2.15]，P=0.84）无关，并且将索拉非尼的使用作为时间变化的协变量。
结论
在切除的组织中存在高危特征的 OLT 受者中预先使用索拉非尼并不能改善 HCC 无复发生存或总生存率。
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