Influence of arsenious acid chemotherapy on tumor recurrence in liver transplant recipients with primary hepatocellular carcinoma

Abstract

Objective To explore the role of arsenious acid on tumor recurrence in liver transplant recipients with primary hepatocellular carcinoma (HCC) extending Milan criteria.Methods Twenty-three patients with HCC extending Milan criterion received intravenous arsenious acid chemotherapy after orthotopic liver transplantation (OLT),while the other 16 patients with similar pretransplant situations did not received chemotherapy after the operation.The difference of patients survival and tumor recurrence were compared.Results All the 39 patients were routinely followed up for 3-32 months.Thirty recipients were found to have tumor recurrence and 16 in chemotherapy group and 14 in non-chemotherapy group.The tumor recurred in lung,liver graft and bones in most of the cases.The total recurrence rate was similar in these two groups,but chemotherapy could delay recurrence after transplantation(14.5±7.5 m vs 10.2±4.6 m,P=0.026).Six-month and 1-year survival rate were similar (91.3% vs 93.7 and 87.0% vs 87.5,respectively),while 2-year survival in chemotherapy group was higher (73.9% vs 50.0%,P=0.037),6-mon tumor-free survival rates in the two groups were similar (87.0% vs 81.2%),1-year and 2-year tumor-free in chemotherapy group were significantly higher than those in non-chemotherapy group (82.6% vs 50.0%,P=0.030 and 65.2% vs 43.7 %,P=0.023).Conclusion Intravenous arsenious acid chemotherapy can delay the tumor recurrence and prolong the survival in liver transplant patients with HCC extending Milan criteria. Key words: Liver transplantation; Primary hepatocellular carcinoma; Arsenious acid; Chemotherapy