Excellent response of VX2 liver metastases to iri delivered from 2 types of microspheres

No. 317 Bridging locoregional therapy enhances long-term survivals in hepatocellular carcinoma patients listed for liver transplant within the milan criteria: a 15-year experience M. Xing, S. Sakaria, R. Dhanasekaran, N. Kokabi, J.C. Camacho, S. Parekh, J.R. Spivey, H.S. Kim; Interventional Radiology and Image-Guided Medicine, Department of Radiology, Emory University School of Medicine, Atlanta, GA; Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA; Emory Transplant Center, Emory University School of Medicine, Atlanta, GA; Division of Interventional Radiology, Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA Purpose: To evaluate the long-term survival benefit of bridging locoregional therapy (LRT) prior to orthotopic liver transplant (OLT) in patients with hepatocellular carcinoma (HCC), within the Milan Criteria and listed for OLT. Materials and Methods: Under IRB approval, our transplant center registry was queried for all HCC patients within the Milan Criteria who were listed for OLT from June 1998 to August 2013. Baseline clinical characteristics, median overall survival (OS) from HCC diagnosis and median OS from OLT were calculated and stratified by LRT and OLT status. Survival analysis was conducted using Kaplan-Meier estimation and log-rank test. Results: A total of 265 HCC patients were listed for OLT 205 underwent OLT and 60 did not. Mean follow-up duration from HCC diagnosis was 7.6 years. Of the 205 transplanted patients, 111 received LRT prior to OLT (Group A), and 94 did not receive LRT (Group B). Both groups were similar for age at diagnosis, gender, race, lobar involvement, HCC etiology and mean largest tumor size (p40.05). Median OS from HCC diagnosis for Groups A and B were 87.3 months and 74.3 months, respectively (p1⁄40.01). Median OS from OLT for Groups A and B were 79.6 months and 64.9 months, respectively (p1⁄40.03). Interval survival rates from HCC diagnosis for Group A vs. B were: 91% vs. 76% (1 year), 85% vs. 65% (2 years), 72% vs. 53% (5 years, p1⁄40.02). Of 60 patients who were listed but did not undergo transplant, 44 received LRT (Group C) and 16 received best supportive care (Group D). Median OS from HCC diagnosis for Groups C and D were 37.1 months and 24.8 months (p1⁄40.03), respectively. Interval survival rates from HCC diagnosis for Group C vs. D were: 48% vs. 31% (1 year), 39% vs. 25% (2 years) and 18% vs. 6% (5 years, p1⁄40.005). Conclusion: Bridging locoregional therapy prior to OLT in patients with HCC within the Milan Criteria demonstrated significantly greater median OS and 5-year survival rates compared to those who did not receive LRT as a bridge to transplantation.