8:08 AM Abstract No. 129 - Chemoembolization of hepatocellular carcinoma as a bridge to liver transplantation: Derived benefit is independent of blood type

Abstract

Purpose Hepatocellular carcinoma (HCC) within Milan criteria progresses rapidly with a reported tumor drop-off (D) rate of 16.9% and 31.8% at 6 and 12 months without therapy. Transhepatic arterial chemoembolization (TACE) is used to decrease D. Given the differences in wait time to transplant (T) depending on blood type, we hypothesized that the decrease in D following TACE would be independent of blood type. Materials and Methods Patients listed for T in the MELD era treated with TACE were reviewed. Excluded patients were T or Results 107 patients were listed: 78 T and 29 D. 63T and 18 D patients met entry criteria. D rate was 8.4% and 10.3% at 6 and 12 months. Cirrhosis etiology was similar between T and D including HBV (6.4% v 5.6%), HCV (85.7% v 72.2%), EtOH (7.9% v 27.8%), and presence of multiple factors (all p>0.05). Listing MELD was 10.6 ± 3.1 for T v 10.7 ± 3.1 for D (p=0.87). AFP > 200 ng/ml was 7.9% for T v 22.2% for D (p=0.09). TACE cycles were 2.3 ± 1.3 for T v 2.5 ± 1.5 for D (p=0.68). Mean days listed was 241 ± 159 (range 65-785) for T v 324 ± 360 (range 55-1491) for D (p=0.35). Blood types are outlined in the Table. The distribution of all blood types was similar for T and D (p=0.92) as was type O versus other types (p=0.56). At logistic regression, blood type (p=0.85), listing MELD (p=0.95), TACE cycle number (p=0.54) and days listed (0.17) did not predict D. Conclusion In similarly matched groups receiving similar TACE cycles, D was independent of blood type including those associated with longer wait times. The rate of D following TACE compared favorably to historic controls Table 1