TBA (19W187)

Comparison Of Potentially Curative Therapies In Hepatocellular Carcinoma – Ireland’s Experience

Author(s)

B. Layard, M. Bourke, D. Houlihan

Department(s)/Institutions

The Liver Transplant Unit, St. Vincent's University Hospital, Dublin

Introduction

Hepatocellular carcinoma (HCC) is a primary aggressive liver tumour. There are multiple treatment modalities, including resection, liver transplant, locoregional therapy and systemic chemotherapy. Transplant is deemed the most superior treatment, with 5-year survival rates being quoted in the region of 80%.

Aims/Background

Assess and compare survival of patients undergoing potentially curative therapies for HCC - resection, liver transplantation and radiofrequency ablation (RFA).

Method

We retrospectively analysed data collated from a prospectively maintained database, at a National Tertiary Referral centre in Ireland, over 5-years. We assessed patients who had resection, RFA or transplant as treatment for HCC, from 01/01/2014 – 31/12/2018. Patient demographics, background liver disease, date of diagnosis, mode of treatment, and date of death were analysed.

Results

162 patients identified. 55 underwent resection and 39 underwent RFA as primary treatment for HCC. 68 patients were listed for transplant. 80% were male. Majority were 60-69 years. 90% had cirrhosis. A Kaplan-Meier curve demonstrates a drop-out of 10-15% in the liver transplant group at 1-year, compared to an almost 100% survival at 18 months for those undergoing RFA or resection. 5-year survival on the curve is 71% for RFA, 61% for transplant and 58% for resection.

Conclusions

Careful patient selection is key to achieve optimal results in each treatment modality. In patients meeting criteria for transplant, consideration must also be given to RFA, or resection if suitable, which can provide patients with similar or better outcomes, but without risk of drop-out at 1 year. This also allows donor grafts to be utilised for other patients in need.