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

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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

Fingerprint

gemcitabine
Adjuvant Chemotherapy
Liver Transplantation
Cisplatin
Hepatocellular Carcinoma
Disease-Free Survival
Drug Therapy
Survival Rate
Leukopenia
Granulocyte Colony-Stimulating Factor
Liver Neoplasms
Neoplasm Metastasis
Liver
Therapeutics

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

Cite this

Preliminary experience with gemcitabine and cisplatin adjuvant chemotherapy after liver transplantation for hepatocellular carcinoma. / Hsieh, Chung-Bao; Chou, Shao-Jiun; Shih, Ming-Lang; Chu, Heng-Cheng; Chu, Chi-Hung; Yu, Jyh-Cherng; Yao, Nai-Shun.

In: European Journal of Surgical Oncology, Vol. 34, No. 8, 2008, p. 906-910.

Research output: Contribution to journalArticle

Hsieh, Chung-Bao ; Chou, Shao-Jiun ; Shih, Ming-Lang ; Chu, Heng-Cheng ; Chu, Chi-Hung ; Yu, Jyh-Cherng ; Yao, Nai-Shun. / Preliminary experience with gemcitabine and cisplatin adjuvant chemotherapy after liver transplantation for hepatocellular carcinoma. In: European Journal of Surgical Oncology. 2008 ; Vol. 34, No. 8. pp. 906-910.
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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. {\circledC} 2007 Elsevier Ltd. All rights reserved.",
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author = "Chung-Bao Hsieh and Shao-Jiun Chou and Ming-Lang Shih and Heng-Cheng Chu and Chi-Hung Chu and Jyh-Cherng Yu and Nai-Shun Yao",
note = "被引用次數:20 Export Date: 22 March 2016 CODEN: EJSOE 通訊地址: Yao, N.-S.; Department of Hematology/Oncology, Department of Internal Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, 114 Taipei, Taiwan; 電子郵件: nancynsy@yahoo.com.tw 化學物質/CAS: cisplatin, 15663-27-1, 26035-31-4, 96081-74-2; gemcitabine, 103882-84-4; Antineoplastic Agents; Cisplatin, 15663-27-1; Deoxycytidine, 951-77-9; gemcitabine, 103882-84-4; Immunosuppressive Agents 參考文獻: Bruix, J., Sherman, M., Llovet, J.M., Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona 2000 EASL conference. European Association for the Study of the Liver (2001) J Hepatol, 35, pp. 421-430; Bruix, J., Llovet, J.M., Prognostic prediction and treatment strategy in hepatocellular carcinoma (2002) Hepatology, 35, pp. 519-524; Farmer, D.G., Rosove, M.H., Shaked, A., Busuttil, R.W., Current treatment modalities for hepatocellular carcinoma (1994) Ann Surg, 219, pp. 236-247; Fong, Y., Kemeny, N., Lawrence, T., Cancer of the liver and biliary tree (2001) Cancer: principles and practice of oncology, pp. 1162-1203. , DeVita V., Hellman S., and Rosenberg S. (Eds), JB Lippincott, Philadelphia; Yao, F.Y., Terrault, N.A., Hepatitis C and hepatocellular carcinoma (2001) Curr Treat Opin Oncol, 2, pp. 473-483; Mazzaferro, V., Regalia, E., Doci, R., Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis (1996) N Engl J Med, 334, pp. 693-699; Ringe, B., Pichlmayr, R., Wittekind, C., Tusch, G., Surgical treatment of hepatocellular carcinoma: experience with liver resection and transplantation in 198 patients (1991) World J Surg, 15, pp. 270-285; Bismuth, H., Chiche, L., Adan, R., Castaing, D., Diamond, T., Dennison, A., Liver resection versus transplantation for hepatocellular carcinoma in cirrhosis (1993) Ann Surg, 218, pp. 145-151; Roayaie, S., Frischer, J., Emre, S.H., Long-term results with multimodal adjuvant therapy and liver transplantation for the treatment of hepatocellular carcinomas larger than 5 cm (2002) Ann Surg, 235, pp. 533-539; Penn, I., Hepatic transplantation for primary and metastatic cancers of the liver (1991) Surgery, 110, pp. 726-735; Yokoyama, I., Todo, S., Iwatsuki, S., Liver transplantation in the treatment of primary liver cancer (1990) Hepatogastroenterology, 37, pp. 188-193; Olthoff, K.M., Rosove, M.H., Shackleton, C.R., Adjuvant chemotherapy improves survival after liver transplantation for hepatocellular carcinoma (1995) Ann Surg, 221 (6), pp. 734-741; Bernal, E., Montero, J.L., Delgado, M., Adjuvant chemotherapy for prevention of recurrence of invasive hepatocellular carcinoma after orthotopic liver transplantation (2006) Transplant Proc, 38 (8), pp. 2495-2498; Soderdahl, G., Backman, L., Isoniemi, H., A prospective, randomized multi-centre trial of systemic adjuvant chemotherapy versus no additional treatment in liver transplantation for hepatocellular carcinoma (2006) Transpl Int, 19 (4), pp. 288-294; Llovet, J.M., Updated treatment approach to hepatocellular carinoma (2005) J Gastroenterol, 40 (3), pp. 225-235; Plunkett, W., Huang, P., Searcy, C.E., Gandhi, V., Gemcitabine: preclinical pharmacology and mechanisms of action (1996) Semin Oncol, 23, pp. 3-15; Graziadei, I., Kelly, T., Schirmer, M., Geisen, F.H., Vogel, W., Konwalinka, G., Antitumor effect of the nucleoside analogs 2-chlorodeoxyadenosine and 2′,2′-difluorodeoxycytidine on human hepatoma HepG2 cells (1998) J Hepatol, 28, pp. 504-509; Yang, T.S., Lin, Y.C., Chen, J.S., Wang, H.M., Wang, C.H., Phase II study of gemcitabine in patients with advanced hepatocellular carcinoma (2000) Cancer, 89, pp. 750-756; Parikh, P.M., Fuloria, J., Babu, G., A phase II study of gemcitabine and cisplatin in patients with advanced hepatocellular carinoma (2005) Trop Gastroenterol, 26 (3), pp. 115-118; Iwatsuki, S., Starzl, T.E., Sheahan, D.G., Hepatic resection versus transplantation for hepatocellular carcinoma (1991) Ann Surg, 214, pp. 221-228; Figueras, J., Jaurrieta, E., Valls, C., Survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma: a comparative study (1997) Hepatology, 25, pp. 1485-1489; Min, A.D., Saxena, R., Thung, S.N., Outcome of hepatitis C patients with and without hepatocellular carcinoma undergoing liver transplantation (1998) Am J Gastroenterol, 93, pp. 2148-2153; Hiatt, J.R., Carmody, I.C., Busuttil, R.W., Should we expand the criteria for hepatocellular carcinoma with living-donor liver transplantation?-no, never (2005) J Hepatol, 43, pp. 573-577; Volk, M.L., Marrero, J.A., Lok, A.S., Ubel, P.A., Who decides? Living donor liver transplantation for advanced hepatocellular carcinoma (2006) Transplantation, 82, pp. 1136-1139",
year = "2008",
doi = "10.1016/j.ejso.2007.11.014",
language = "English",
volume = "34",
pages = "906--910",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
number = "8",

}

TY - JOUR

T1 - Preliminary experience with gemcitabine and cisplatin adjuvant chemotherapy after liver transplantation for hepatocellular carcinoma

AU - Hsieh, Chung-Bao

AU - Chou, Shao-Jiun

AU - Shih, Ming-Lang

AU - Chu, Heng-Cheng

AU - Chu, Chi-Hung

AU - Yu, Jyh-Cherng

AU - Yao, Nai-Shun

N1 - 被引用次數:20 Export Date: 22 March 2016 CODEN: EJSOE 通訊地址: Yao, N.-S.; Department of Hematology/Oncology, Department of Internal Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, 114 Taipei, Taiwan; 電子郵件: nancynsy@yahoo.com.tw 化學物質/CAS: cisplatin, 15663-27-1, 26035-31-4, 96081-74-2; gemcitabine, 103882-84-4; Antineoplastic Agents; Cisplatin, 15663-27-1; Deoxycytidine, 951-77-9; gemcitabine, 103882-84-4; Immunosuppressive Agents 參考文獻: Bruix, J., Sherman, M., Llovet, J.M., Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona 2000 EASL conference. European Association for the Study of the Liver (2001) J Hepatol, 35, pp. 421-430; Bruix, J., Llovet, J.M., Prognostic prediction and treatment strategy in hepatocellular carcinoma (2002) Hepatology, 35, pp. 519-524; Farmer, D.G., Rosove, M.H., Shaked, A., Busuttil, R.W., Current treatment modalities for hepatocellular carcinoma (1994) Ann Surg, 219, pp. 236-247; Fong, Y., Kemeny, N., Lawrence, T., Cancer of the liver and biliary tree (2001) Cancer: principles and practice of oncology, pp. 1162-1203. , DeVita V., Hellman S., and Rosenberg S. (Eds), JB Lippincott, Philadelphia; Yao, F.Y., Terrault, N.A., Hepatitis C and hepatocellular carcinoma (2001) Curr Treat Opin Oncol, 2, pp. 473-483; Mazzaferro, V., Regalia, E., Doci, R., Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis (1996) N Engl J Med, 334, pp. 693-699; Ringe, B., Pichlmayr, R., Wittekind, C., Tusch, G., Surgical treatment of hepatocellular carcinoma: experience with liver resection and transplantation in 198 patients (1991) World J Surg, 15, pp. 270-285; Bismuth, H., Chiche, L., Adan, R., Castaing, D., Diamond, T., Dennison, A., Liver resection versus transplantation for hepatocellular carcinoma in cirrhosis (1993) Ann Surg, 218, pp. 145-151; Roayaie, S., Frischer, J., Emre, S.H., Long-term results with multimodal adjuvant therapy and liver transplantation for the treatment of hepatocellular carcinomas larger than 5 cm (2002) Ann Surg, 235, pp. 533-539; Penn, I., Hepatic transplantation for primary and metastatic cancers of the liver (1991) Surgery, 110, pp. 726-735; Yokoyama, I., Todo, S., Iwatsuki, S., Liver transplantation in the treatment of primary liver cancer (1990) Hepatogastroenterology, 37, pp. 188-193; Olthoff, K.M., Rosove, M.H., Shackleton, C.R., Adjuvant chemotherapy improves survival after liver transplantation for hepatocellular carcinoma (1995) Ann Surg, 221 (6), pp. 734-741; Bernal, E., Montero, J.L., Delgado, M., Adjuvant chemotherapy for prevention of recurrence of invasive hepatocellular carcinoma after orthotopic liver transplantation (2006) Transplant Proc, 38 (8), pp. 2495-2498; Soderdahl, G., Backman, L., Isoniemi, H., A prospective, randomized multi-centre trial of systemic adjuvant chemotherapy versus no additional treatment in liver transplantation for hepatocellular carcinoma (2006) Transpl Int, 19 (4), pp. 288-294; Llovet, J.M., Updated treatment approach to hepatocellular carinoma (2005) J Gastroenterol, 40 (3), pp. 225-235; Plunkett, W., Huang, P., Searcy, C.E., Gandhi, V., Gemcitabine: preclinical pharmacology and mechanisms of action (1996) Semin Oncol, 23, pp. 3-15; Graziadei, I., Kelly, T., Schirmer, M., Geisen, F.H., Vogel, W., Konwalinka, G., Antitumor effect of the nucleoside analogs 2-chlorodeoxyadenosine and 2′,2′-difluorodeoxycytidine on human hepatoma HepG2 cells (1998) J Hepatol, 28, pp. 504-509; Yang, T.S., Lin, Y.C., Chen, J.S., Wang, H.M., Wang, C.H., Phase II study of gemcitabine in patients with advanced hepatocellular carcinoma (2000) Cancer, 89, pp. 750-756; Parikh, P.M., Fuloria, J., Babu, G., A phase II study of gemcitabine and cisplatin in patients with advanced hepatocellular carinoma (2005) Trop Gastroenterol, 26 (3), pp. 115-118; Iwatsuki, S., Starzl, T.E., Sheahan, D.G., Hepatic resection versus transplantation for hepatocellular carcinoma (1991) Ann Surg, 214, pp. 221-228; Figueras, J., Jaurrieta, E., Valls, C., Survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma: a comparative study (1997) Hepatology, 25, pp. 1485-1489; Min, A.D., Saxena, R., Thung, S.N., Outcome of hepatitis C patients with and without hepatocellular carcinoma undergoing liver transplantation (1998) Am J Gastroenterol, 93, pp. 2148-2153; Hiatt, J.R., Carmody, I.C., Busuttil, R.W., Should we expand the criteria for hepatocellular carcinoma with living-donor liver transplantation?-no, never (2005) J Hepatol, 43, pp. 573-577; Volk, M.L., Marrero, J.A., Lok, A.S., Ubel, P.A., Who decides? Living donor liver transplantation for advanced hepatocellular carcinoma (2006) Transplantation, 82, pp. 1136-1139

PY - 2008

Y1 - 2008

N2 - 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.

AB - 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.

KW - Disease-free survival rate

KW - Disease-specific survival rate

KW - Gemcitabine

KW - Hepatocellular carcinoma

KW - Liver transplantation

KW - Milan criteria

KW - cisplatin

KW - gemcitabine

KW - adjuvant chemotherapy

KW - adult

KW - article

KW - cancer survival

KW - clinical trial

KW - comparative study

KW - controlled study

KW - disease free survival

KW - drug tolerability

KW - fatigue

KW - female

KW - human

KW - infection

KW - leukopenia

KW - liver cell carcinoma

KW - liver transplantation

KW - major clinical study

KW - male

KW - nausea and vomiting

KW - outcome assessment

KW - priority journal

KW - survival rate

KW - time series analysis

KW - treatment outcome

KW - Antineoplastic Agents

KW - Carcinoma, Hepatocellular

KW - Chemotherapy, Adjuvant

KW - Cisplatin

KW - Deoxycytidine

KW - Disease-Free Survival

KW - Female

KW - Humans

KW - Immunosuppressive Agents

KW - Liver Neoplasms

KW - Liver Transplantation

KW - Male

KW - Middle Aged

KW - Treatment Outcome

U2 - 10.1016/j.ejso.2007.11.014

DO - 10.1016/j.ejso.2007.11.014

M3 - Article

VL - 34

SP - 906

EP - 910

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 8

ER -