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Impact of everolimus on survival after liver transplantation for hepatocellular carcinoma

Authors
 Incheon Kang  ;  Jae Geun Lee  ;  Sung Hoon Choi  ;  Hyun Jeong Kim  ;  Dai Hoon Han  ;  Gi Hong Choi  ;  Myoung Soo Kim  ;  Jin Sub Choi  ;  Soon Il Kim  ;  Dong Jin Joo 
Citation
 CLINICAL AND MOLECULAR HEPATOLOGY, Vol.27(4) : 589-602, 2021-10 
Journal Title
CLINICAL AND MOLECULAR HEPATOLOGY
ISSN
 2287-2728 
Issue Date
2021-10
Keywords
Hepatocellular carcinoma ; Immunosuppression ; Liver transplantation ; Recurrence ; Survival
Abstract
Background/aims: This study aimed to investigate whether everolimus (EVR) affects long-term survival after liver transplantation (LT) in patients with hepatocellular carcinoma (HCC).

Methods: The data from 303 consecutive patients with HCC who had undergone LT from January 2012 to July 2018 were retrospectively reviewed. The patients were divided into two groups: 1) patients treated with EVR in combination with calcineurin inhibitors (CNIs) (EVR group; n=114) and 2) patients treated with CNI-based therapy without EVR (non-EVR group; n=189). Time to recurrence (TTR) and overall survival (OS) after propensity score (PS) matching were compared between the groups, and prognostic factors for TTR and OS were evaluated.

Results: The EVR group exhibited more aggressive tumor biology than the non-EVR group, such as a higher number of tumors (P=0.003), a higher prevalence of microscopic vascular invasion (P=0.017) and exceeding Milan criteria (P=0.029). Compared with the PS-matched non-EVR group, the PS-matched EVR group had significantly better TTR (P<0.001) and OS (P<0.001). In multivariable analysis, EVR was identified as an independent prognostic factor for TTR (hazard ratio [HR], 0.248; P=0.001) and OS (HR, 0.145; P<0.001).

Conclusion: Combined with CNIs, EVR has the potential to prolong long-term survival in patients undergoing LT for HCC. These findings warrant further investigation in a well-designed prospective study.
Files in This Item:
T202104531.pdf Download
DOI
10.3350/cmh.2021.0038
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Soon Il(김순일) ORCID logo https://orcid.org/0000-0002-0783-7538
Kim, Hyun Jeong(김현정)
Lee, Jae Geun(이재근) ORCID logo https://orcid.org/0000-0002-6722-0257
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
Han, Dai Hoon(한대훈) ORCID logo https://orcid.org/0000-0003-2787-7876
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/185974
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