A prospective, randomized, multi-centre trial of systemic adjuvant chemotherapy versus no additional treatment in liver transplantation for hepatocellular carcinoma

• The role of adjuvant systemic chemotherapy in liver transplantation (LT) for hepatocellular carcinoma (HCC) is controversial. Here, we report the results of a Nordic prospective, randomized, multi-centre trial of systemic low-dose doxorubicin in patients with HCC. Between February 1996 and April 2004, 46 patients were randomized to receive either neoadjuvant doxorubicin in combination with LT (chemo group; n = 19) or LT alone (control group; n = 27). In the chemo group, doxorubicin was administered intravenously, 10 mg/m(2) weekly, starting from acceptance onto the waiting list for LT. One intraoperative dose of 15 mg/m(2) was given, and postoperatively doxorubicin was given weekly at a dose of 10 mg/m(2), depending on the clinical course, up to a cumulative dose of 400 mg/m(2). Actuarial, 3-year overall survival (OS) and disease-free survival (DFS) in the control group were 70% and 50%, respectively. In the chemo group, both OS and DFS were 63%. Freedom from recurrence at 3 years was 55% in the control group and 74% in the chemo group. None of the differences was statistically significant. Neoadjuvant treatment with systemic low-dose doxorubicin seems not to improve either survival or freedom from recurrence in patients with HCC undergoing LT.

Nyckelord

Aged

Antibiotics

Antineoplastic/adverse effects/*therapeutic use

Carcinoma

Hepatocellular/*drug therapy/mortality/*surgery

Chemotherapy

Adjuvant

Disease-Free Survival

Doxorubicin/adverse effects/*therapeutic use

Female

Humans

Liver Neoplasms/*drug therapy/mortality/*surgery

*Liver Transplantation

Male

Middle Aged

Prospective Studies

Recurrence

Risk Factors

Survival Rate

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)