Preliminary experience with gemcitabine and cisplatin adjuvant chemotherapy after liver transplantation for hepatocellular carcinoma

Chung-Bao Hsieh, Shao-Jiun Chou, Ming-Lang Shih, Heng-Cheng Chu, Chi-Hung Chu, Jyh-Cherng Yu, Nai-Shun Yao

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Aim: Liver transplantation (LT) criteria for treatment of hepatocellular carcinoma (HCC) were refined to improved survival and disease-free rates. Adjuvant chemotherapy might eliminate disseminated tumor cells after removal of the primary liver cancer and thereby benefit LT recipients. Our purpose was to evaluate the effect of an adjuvant chemotherapy (gemcitabine and cisplatin) on outcome of patients treated with LT for HCC. Methods: Of the 99 patients who underwent liver transplantation from October 2001 through February 2006, there were 58 with HCC. Nine patients with extra-hepatic metastasis and four who died for noncancer-related reasons were excluded. Three groups (total n = 45) were compared: Group A (n = 15) met the Milan criteria and did not receive study chemotherapy, Group B (n = 13) did not fit the Milan criteria and did not receive chemotherapy, and Group C (n = 17) did not fit the Milan criteria and received gemcitabine and cisplatin. Results: The chemotherapy regimen was well tolerated. Leukopenia, the need for granulocyte colony-stimulating factor treatment, or both occurred in four patients. The disease-specific survival rates were better for groups A and C than for group B (p = 0.02) and the disease-free survival rates were also better for groups A and C than for group B (p = 0.01). Conclusions: Systemic gemcitabine and cisplatin may improve disease-specific and disease-free survival in HCC patients who do not meet the Milan criteria after LT. © 2007 Elsevier Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)906-910
Number of pages5
JournalEuropean Journal of Surgical Oncology
Volume34
Issue number8
DOIs
Publication statusPublished - 2008
Externally publishedYes

Keywords

  • Disease-free survival rate
  • Disease-specific survival rate
  • Gemcitabine
  • Hepatocellular carcinoma
  • Liver transplantation
  • Milan criteria
  • cisplatin
  • gemcitabine
  • adjuvant chemotherapy
  • adult
  • article
  • cancer survival
  • clinical trial
  • comparative study
  • controlled study
  • disease free survival
  • drug tolerability
  • fatigue
  • female
  • human
  • infection
  • leukopenia
  • liver cell carcinoma
  • liver transplantation
  • major clinical study
  • male
  • nausea and vomiting
  • outcome assessment
  • priority journal
  • survival rate
  • time series analysis
  • treatment outcome
  • Antineoplastic Agents
  • Carcinoma, Hepatocellular
  • Chemotherapy, Adjuvant
  • Cisplatin
  • Deoxycytidine
  • Disease-Free Survival
  • Female
  • Humans
  • Immunosuppressive Agents
  • Liver Neoplasms
  • Liver Transplantation
  • Male
  • Middle Aged
  • Treatment Outcome

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