{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T19:57:10Z","timestamp":1760299030401},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":221,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:p>Transarterial chemoembolization (TACE) is a common treatment for patients with hepatocellular carcinoma (HCC) who are awaiting liver transplantation (LT). The aim of this study was to assess the impact of multiple TACE treatments on tumor necrosis, tumor recurrence, and survival in these patients. A retrospective analysis was performed for 104 consecutive patients undergoing LT for HCC from January 2002 to December 2009 who were treated with TACE before LT. The number of TACE treatments was not associated with tumor necrosis in the explant. After a median follow\u2010up of 69 months (range\u2009=\u20090\u2010123 months), 14 of the 104 patients (13%) developed recurrent HCC after LT. Recurrence had a significant relationship with a short interval between the diagnosis of HCC and LT (\u22646 months) in univariate and multivariate analyses [<jats:italic toggle=\"yes\">P =<\/jats:italic> 0.029, odds ratio (OR)\u2009=\u200919.2]. Patients subjected to a single TACE treatment were more likely to experience recurrence, although this finding was not confirmed in the multivariate analysis. No significant relationship was observed between tumor necrosis in the explant and recurrence. The mean overall survival was 102.8 months (95% confidence interval\u2009=\u200994.9\u2010110.8 months) with 1\u2010, 3\u2010, and 5\u2010year survival rates of 91%, 89%, and 84% respectively. In the univariate survival analysis, the presence of ascites before TACE, a waiting time\u2009\u2264\u20099 months, and tumor characteristics at the pathological examination were statistically associated with shorter survival. In the multivariate analysis, only vascular invasion (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.001, OR\u2009=\u20097.99) remained independently associated with shorter survival. The number of TACE treatments was not associated with survival. In conclusion, multiple TACE treatments were not associated with a higher risk of recurrence or shorter survival. Continued use of TACE should be considered as indicated if the patient and lesions are suitable for retreatment. A shorter waiting time before LT is related to an increased risk of recurrence and decreased survival after LT for HCC. These data could reflect the presence of more aggressive tumor biology and may be useful for guiding organ allocation policy to consider a minimum observation period before LT for regions with shorter wait times. <jats:italic toggle=\"yes\">Liver Transpl 21:248\u2010257, 2015<\/jats:italic>. \u00a9 2014 AASLD.<\/jats:p>","DOI":"10.1002\/lt.24041","type":"journal-article","created":{"date-parts":[[2014,11,5]],"date-time":"2014-11-05T08:55:22Z","timestamp":1415177722000},"page":"248-257","source":"Crossref","is-referenced-by-count":24,"title":["Impact of multiple transarterial chemoembolization treatments on hepatocellular carcinoma for patients awaiting liver transplantation"],"prefix":"10.1097","volume":"21","author":[{"given":"Eleonora","family":"Terzi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Gastroenterology,University of Bologna, Sant'Orsola\u2010Malpighi Polyclinic,Bologna,Italy"},{"name":"Division of Transplant Surgery,William J. von Liebig Transplant Center,Mayo Clinic,Rochester,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Ray Kim","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,William J. von Liebig Transplant Center,Mayo Clinic,Rochester,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,William J. von Liebig Transplant Center,Mayo Clinic,Rochester,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Charlton","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,William J. von Liebig Transplant Center,Mayo Clinic,Rochester,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Schmeltzer","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,William J. von Liebig Transplant Center,Mayo Clinic,Rochester,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory J.","family":"Gores","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,William J. von Liebig Transplant Center,Mayo Clinic,Rochester,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James C.","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Radiology,Mayo Clinic,Rochester,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas C.","family":"Smyrk","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology,Mayo Clinic,Rochester,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie K.","family":"Heimbach","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery,William J. von Liebig Transplant Center,Mayo Clinic,Rochester,MN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2015,1,23]]},"reference":[{"key":"lt24041-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1056\/NEJM199603143341104","article-title":"Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis","volume":"334","year":"1996","journal-title":"N Engl J Med"},{"key":"lt24041-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1016\/S1470-2045(11)70175-9","article-title":"for OLT for HCC Consensus Group. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report","volume":"13","year":"2012","journal-title":"Lancet Oncol"},{"key":"lt24041-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1002\/lt.23394","article-title":"Increasing disparity in waitlist mortality rates with increased Model for End\u2010Stage Liver Disease scores for candidates with hepatocellular carcinoma versus candidates without hepatocellular carcinoma","volume":"18","year":"2012","journal-title":"Liver Transpl"},{"key":"lt24041-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"2362","DOI":"10.1111\/j.1600-6143.2011.03735.x","article-title":"MELD exceptions and rates of waiting list outcomes","volume":"11","year":"2011","journal-title":"Am J Transplant"},{"key":"lt24041-bib-0005-20240115","first-page":"1643","article-title":"Hepatocellular carcinoma patients are advantaged in the current liver transplant allocation system","volume":"10","year":"2010","journal-title":"Am J Transplant"},{"key":"lt24041-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.jhep.2012.09.021","article-title":"Hepatocellular carcinoma locoregional therapies for patients in the waiting list. Impact on transplantability and recurrence rate","volume":"58","year":"2013","journal-title":"J Hepatol"},{"key":"lt24041-bib-0007-20240115","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1148\/radiol.12121698","article-title":"New OPTN\/UNOS policy for liver transplant allocation: standardization of liver imaging, diagnosis, classification, and reporting of hepatocellular carcinoma","volume":"266","year":"2013","journal-title":"Radiology"},{"key":"lt24041-bib-0008-20240115","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1136\/gut.50.1.123","article-title":"Cost effectiveness of adjuvant therapy for hepatocellular carcinoma during the waiting list for liver transplantation","volume":"50","year":"2002","journal-title":"Gut"},{"key":"lt24041-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1002\/lt.21999","article-title":"Report of a national conference on liver allocation in patients with hepatocellular carcinoma in the United States","volume":"16","year":"2010","journal-title":"Liver Transpl"},{"key":"lt24041-bib-0010-20240115","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1097\/01.TP.0000145892.97114.EE","article-title":"Partial necrosis on hepatocellular carcinoma nodules facilitates tumor recurrence after liver transplantation","volume":"78","year":"2004","journal-title":"Transplantation"},{"key":"lt24041-bib-0011-20240115","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/j.1399-0012.2009.01111.x","article-title":"Role of transarterial chemoembolization for hepatocellular carcinoma before liver transplantation with special consideration of tumor necrosis","volume":"23","year":"2009","journal-title":"Clin Transplant"},{"key":"lt24041-bib-0012-20240115","first-page":"1208","article-title":"for Practice Guidelines Committee of the American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma","volume":"42","year":"2005","journal-title":"Hepatology"},{"key":"lt24041-bib-0013-20240115","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/S0168-8278(01)00130-1","article-title":"EASL Panel of Experts on HCC. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona\u20102000 EASL conference. European Association for the Study of the Liver","volume":"35","year":"2001","journal-title":"J Hepatol"},{"key":"lt24041-bib-0014-20240115","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1016\/j.humpath.2004.06.006","article-title":"Recommendations for the reporting of tissues removed as part of the surgical treatment of malignant liver tumors","volume":"35","year":"2004","journal-title":"Hum Pathol"},{"key":"lt24041-bib-0015-20240115","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1002\/1097-0142(195405)7:3<462::AID-CNCR2820070308>3.0.CO;2-E","article-title":"Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies","volume":"7","year":"1954","journal-title":"Cancer"},{"key":"lt24041-bib-0016-20240115","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/j.jhep.2011.12.001","article-title":"European Organisation for Research and Treatment of Cancer. EASL\u2010EORTC clinical practice guidelines: management of hepatocellular carcinoma","volume":"56","year":"2012","journal-title":"J Hepatol"},{"key":"lt24041-bib-0017-20240115","doi-asserted-by":"crossref","first-page":"628","DOI":"10.4065\/82.5.628","article-title":"Treatment options for hepatobiliary and pancreatic cancer","volume":"82","year":"2007","journal-title":"Mayo Clin Proc"},{"key":"lt24041-bib-0018-20240115","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1002\/hep.24246","article-title":"Efficacy of selective transarterial chemoembolization in inducing tumor necrosis in small (<5 cm) hepatocellular carcinomas","volume":"53","year":"2011","journal-title":"Hepatology"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.24041","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-201502000-00014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T00:10:45Z","timestamp":1705277445000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-201502000-00014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,23]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.24041","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"value":"1527-6465","type":"print"},{"value":"1527-6473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,23]]}}}