Impact of everolimus on survival after liver transplantation for hepatocellular carcinoma
- Author:
Incheon KANG
1
;
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
Author Information
- Publication Type:Original Article
- From:Clinical and Molecular Hepatology 2021;27(4):589-602
- CountryRepublic of Korea
- Language:English
-
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).
Conclusions: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.
