1 (edited by PCL1029 Thu, 19 Apr 2012 17:25:15)

Topic: Predictors of dropout and Recurrence inCCA Liver Transplant from Mayo

Hi, everyone,

In a study that will be published soon about" Predictors pf Pre-transpant dropout and post-transplant recurrence in patient with perihilar CCA" from Mayo Clinic.
there are some interesting findings.

1. The study was done between 1/1993 to 10/2010. Median age was 51 (range 19-70).

2. Of 199 patients,62 pts (31%)dropout  & 131 pt received liver transplant.and  72% of the 199 patients are male and 127(64%) had underlying PSC.

3.    Predictors of dropout:tumor>/=3cm; CA19-9>500;malignant biopsy and  MELD score>/=20.

4.  A total of 26 patients(20%) developed cancer recurrence at a Median of 23 months(1-128) after transplantation.

5.  Predictors of recurrence:residual tumor cells on explant (the liver that took out from the patient)was the strongest predictor,with a near10 fold increased risk.;elevated CA19-9 level and encasement of the portal vein(related to increase tumor burden for the patient) are risk factors too.

7.currently there are no  proven benefit of adjuvant therapy for recurrence.

8. 61 patients  with residual tumor cells , but 38 out of the  61 patients with residual cells did not develop recurrence were not DIFFERENT from those who did,suggesting of inherent tumor biologic differences of individuals in response to the chemoradiotherapy before transplantation which may determine the outcome of recurrence.

9.The waiting time is not a factor associated with risk of recurrence;the reason may be contribute to  the response to neoadjuvant therapy  rather than time before the transplant.

10 .Age and  PSC  were not significant  factor in the analyses and 1,2,and 5 year recurrence free survival for perihilar CCA=87%,80% and 68% .

from Murad SD;Ray Kim t,Therneau T;Gores GJ;RosenCBmartenson "Predictors of pre-transplant dropout and post-transplant recurrence in patients with perihiliar chonalgiocarcinoma" - pre-print copy from Hepatology(Baltmore Md.). Feb.2012.

also see this link for related study.

http://www.gastrojournal.org/article/S0 … 2/abstract
Thanks to Gavin also.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: Predictors of dropout and Recurrence inCCA Liver Transplant from Mayo

Thanks Percy and Gavin. I am not very good at "medical journal info" but I think this was a positive study, either way I am proving it works!! LOL!
Lots of prayers-Cathy

Re: Predictors of dropout and Recurrence inCCA Liver Transplant from Mayo

Thanks Percy for giving us more info on the study. Hopefully it will be published online soon so that others can read it too.

Thanks again.

Gavin

Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.

Re: Predictors of dropout and Recurrence inCCA Liver Transplant from Mayo

Hello there,

I am very interested in reading the entire article from the Mayo group (our doctors, actually). I went to the link, but could only get the abstract. Do you have a PDF of the whole article? Just checking.

thanks!
Jenny

Re: Predictors of dropout and Recurrence inCCA Liver Transplant from Mayo

Hi,
Due to copy right laws ,I can only summarize the article for members to use.
I am sorry.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.