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Article: Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on Outcomes.

Franchi, Eloisa / Dondossola, Daniele Eliseo / Marini, Giulia Maria Francesca / Iavarone, Massimo / Del Prete, Luca / Di Benedetto, Clara / Donato, Maria Francesca / Antonelli, Barbara / Lampertico, Pietro / Caccamo, Lucio

Cancers

2024  Volume 16, Issue 5

Abstract: The outcome of liver transplantation (LT) for hepatocarcinoma (HCC) is strongly influenced by HCC staging, which is based on radiological examinations in a pre-LT setting; concordance between pre-LT radiological and definitive pathological staging ... ...

Abstract The outcome of liver transplantation (LT) for hepatocarcinoma (HCC) is strongly influenced by HCC staging, which is based on radiological examinations in a pre-LT setting; concordance between pre-LT radiological and definitive pathological staging remains controversial. To address this issue, we retrospectively analyzed our LT series to assess concordance between radiology and pathology and to explore the factors associated with poor concordance and outcomes. We included all LTs with an HCC diagnosis performed between 2013 and 2018. Concordance (Co group) was defined as a comparable tumor burden in preoperative imaging and post-transplant pathology; otherwise, non-concordance was diagnosed (nCo group). Concordance between radiology and pathology was observed in 32/134 patients (Co group, 24%). The number and diameter of the nodules were higher when nCo was diagnosed, as was the number of pre-LT treatments. Although concordance did not affect survival, more than three pre-LT treatments led to a lower disease-free survival. Patients who met the Milan Criteria (Milan-in patients) were more likely to receive ≥three prior treatments, leading to a lower survival in multi-treated Milan-in patients than in other Milan-in patients. In conclusion, the concordance rate between the pre-LT imaging and histopathological results was low in patients with a high number of nodules. Multiple bridging therapies reduce the accuracy of pre-LT imaging in predicting HCC stages and negatively affect outcomes after LT.
Language English
Publishing date 2024-03-04
Publishing country Switzerland
Document type Journal Article
ZDB-ID 2527080-1
ISSN 2072-6694
ISSN 2072-6694
DOI 10.3390/cancers16051043
Database MEDical Literature Analysis and Retrieval System OnLINE

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