American Journal of Cancer Prevention
ISSN (Print): 2328-7314 ISSN (Online): 2328-7322 Website: Editor-in-chief: Nabil Abdel-Hamid
Open Access
Journal Browser
American Journal of Cancer Prevention. 2016, 4(1), 18-22
DOI: 10.12691/ajcp-4-1-4
Open AccessMeta-Analysis

The Effect of Local Regional Therapy on Post-transplantation Survival Rate in Patients with Hepatocellular Carcinoma

Wei Chen1, Xiaoli Yang2 and Yakun Wu3,

1Department of General Surgery, Hospital of traditional Chinese medicine of Yubei, Chongqing, 400010, China

2Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China

3Department of Hepatobiliary Surgery, Suining Central Hospital, Suining 629000, China

Pub. Date: April 26, 2016

Cite this paper:
Wei Chen, Xiaoli Yang and Yakun Wu. The Effect of Local Regional Therapy on Post-transplantation Survival Rate in Patients with Hepatocellular Carcinoma. American Journal of Cancer Prevention. 2016; 4(1):18-22. doi: 10.12691/ajcp-4-1-4


Background and Objective: This study aims to use meta-analysis to evaluate whether pre-transplantation local regional therapy (LRT) can improve the survival of patients with hepatocellular carcinoma who accepted liver transplantation. Methods: Relevant studies were identified by searching PUBMED, EMBASE and Web of Science Datebases up to May 2015. Endpoints were 1 year, 3 years, and 5 years survival rate after liver transplantation. Results: Analysis of nine retrospective studies including 1097 patients did not reveal significant difference in 1year, 3 years and 5 years survival rate between the patients who got LRT or not. Analysis of four retrospective studies including 504 patients showed patients with complete response to LRT have higher 5 years survival rate. Conclusions: The results of this meta-analysis suggest that the patients with complete response to LRT have higher post-transplantation survival rate. But LRT before liver transplantation can’t improve the overall survival rate.

liver transplantation hepatocellular carcinoma local regional therapy meta-analysis

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D, “Global cancer statistics”, CA Cancer J Clin,61(2):69-90, Mar-Apr 2011.
[2]  Duan C, Liu M, Zhang Z, Ma K, Bie P, “Radiofrequency ablation versus hepatic resection for the treatment of early-stage hepatocellular carcinoma meeting Milan criteria: a systematic review and meta-analysis”, World J Surg Oncol,11 (1):190-199, Aug 2013.
[3]  Forner A1, Reig ME, de Lope CR, Bruix J, “Current strategy for staging and treatment: the BCLC update and future prospects”, Semin Liver Dis, 30(1):61-74, Feb 2010.
[4]  Sourianarayanane A, El-Gazzaz G, Sanabria JR, Menon KV, Quintini C, Hashimoto K, Kelly D, Eghtesad B, Miller C, Fung J, Aucejo F, “Loco-regional therapy in patients with Milan Criteria-compliant hepatocellular carcinoma and short waitlist time to transplant: an outcome analysis”. HPB (Oxford),14(5):325-32, May 2012.
[5]  Kim PT, Onaca N, Chinnakotla S, Davis GL, Jennings LW, McKenna GJ, Ruiz RM, Levy MF, Goldstein R, Klintmalm GB, “Tumor biology and pre-transplant locoregional treatments determine outcomes in patients with T3 hepatocellular carcinoma undergoing liver transplantation”, Clin Transplant, 27(2):311-8, Mar-Apr 2013.
[6]  Bharat A, Brown DB, Crippin JS, Gould JE, Lowell JA, Shenoy S, Desai NM, Chapman WC, “Pre-liver transplantation locoregional adjuvant therapy for hepatocellular carcinoma as a strategy to improve longterm survival”, J Am Coll Surg 203(4):411-20, Oct 2006.
[7]  Cucchetti A, Cescon M, Bigonzi E, Piscaglia F, Golfieri R, Ercolani G, Cristina Morelli M, Ravaioli M, Daniele Pinna A, “Priority of candidates with hepatocellular carcinoma awaiting liver transplantation can be reduced after successful bridge therapy”, Liver Transpl, 17 (11):1344-54. Nov 2011.
[8]  Bargellini I, Vignali C, Cioni R, Petruzzi P, Cicorelli A, Campani D, De Simone P, Filipponi F, Bartolozzi C, “Hepatocellular carcinoma: CT for tumor response after transarterial chemoembolization in patients exceeding Milan criteria--selection parameter for liver transplantation”, Radiology, 255 (1):289-300, Apr 2010.
[9]  Millonig G, Graziadei IW, Freund MC, Jaschke W, Stadlmann S, Ladurner R, Margreiter R, Vogel W, “Response to preoperative chemoembolization correlates with outcome after liver transplantation in patients with hepatocellular carcinoma” Liver Transpl, 13(2):272-9, Feb 2007.
[10]  Allard MA, Sebagh M, Ruiz A, Guettier C, Paule B, Vibert E, Cunha AS, Cherqui D, Samuel D, Bismuth H, Castaing D, Adam R, “Does pathological response after transarterial chemoembolization for hepatocellular carcinoma in cirrhotic patients with cirrhosis predict outcome after liver resection or transplantation?” J Hepatol, 63(1):83-92, Jul 2015.
[11]  Choi H, Charnsangavej C, Faria SC, Macapinlac HA, Burgess MA, Patel SR, Chen LL, Podoloff DA, Benjamin RS, “Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria”, J Clin Oncol, 25(13):1753-1759, May 2007.
[12]  Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verwei J, “New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)”, Eur J Cancer, 45(2):228–247, Jan 2009.
[13]  Eswaran SL, Pierce K, Weaver F, Rogers T, Brems JJ, Sontag SJ, Borge M, “Transarterial chemoembolization for HCC in patients with extensive liver transplantation waiting times”, Angiology, 63(3):206-12, Apr 2012.
[14]  DuBay DA, Sandroussi C, Kachura JR, Ho CS, Beecroft JR, Vollmer CM, Ghanekar A, Guba M, Cattral MS, McGilvray ID, Grant DR, Greig PD, “Radiofrequency ablation of hepatocellular carcinoma as a bridge to liver transplantation”, HPB (Oxford), 13(1):24-32, Jan 2011.
[15]  Heckman JT, Devera MB, Marsh JW, Fontes P, Amesur NB, Holloway SE, Nalesnik M, Geller DA, Steel JL, Gamblin TC, “Bridging locoregional therapy for hepatocellular carcinoma prior to liver transplantation”, Ann Surg Oncol, 15(11):3169-77. Nov 2008.
[16]  Maluf DG, Stravitz RT, Williams B, Cotterell AH, Mas VR, Heuman D, Luketic V, Shiffman ML, Sterling R, Posner MP, Fisher RA, “Multimodality therapy and liver transplantation in patients with cirrhosis and hepatocellular carcinoma: 6 years, single-center experience”, Transplant Proc, 39(1):153-9, Jan-Feb 2007.
[17]  Stockland AH, Walser EM, Paz-Fumagalli R, McKinney JM, May GR, “Preoperative chemoembolization in patients with hepatocellular carcinoma undergoing liver transplantation: influence of emergent versus elective procedures on patient survival and tumor recurrence rate”, Cardiovasc Intervent Radiol 30(5):888-93, Sep-Oct 2007.
[18]  Pérez SB, Meneu JC, Moreno E, García I, Moreno A, Fundora Y, “Is transarterial chemoembolization necessary before liver transplantation for hepatocellular carcinoma?” Am J Surg 190 (3):383-7, Sep 2005.
[19]  Decaens T, Roudot-Thoraval F, Bresson-Hadni S, Meyer C, Gugenheim J, Durand F, Bernard PH, Boillot O, Boudjema K, Calmus Y, Hardwigsen J, Ducerf C, Pageaux GP, Dharancy S, Chazouilleres O, Dhumeaux D, Cherqui D, Duvoux C, “Impact of pretransplantation transarterial chemoembolization on survival and recurrence after liver transplantation for hepatocellular carcinoma”, Liver Transpl, 11(7):767-75, Jul 2005.
[20]  Graziadei IW, Sandmueller H, Waldenberger P, Koenigsrainer A, Nachbaur K, Jaschke W, Margreiter R, Vogel W, “Chemoembolization followed by liver transplantation for hepatocellular carcinoma impedes tumor progression while on the waiting list and leads to excellent outcome”, Liver Transpl 9(6):557-63, Jun 2003.
[21]  Shillcutt SK, Ringenberg KJ, Chacon MM, Brakke TR, Montzingo CR, Lyden ER, Schulte TE, Porter TR, Lisco SJ, “Liver Transplantation: Intraoperative Transesophageal Echocardiography Findings and Relationship to Major Postoperative Adverse Cardiac Events”, J Cardiothorac Vasc Anesth 30(1):107-14, Jan 2016.