Carefully selected patients with locally advanced, unresectable intrahepatic cholangiocarcinoma (iCCA) may have acceptable long-term survival after liver transplantation, according to a new study presented at the Cholangiocarcinoma Foundation Annual Conference.

The research team found that although recurrences occurred in these patients, they could be treated with resection and systemic therapy.

“Overall survival at 1-, 3-, and 5-years was 100%, 71%, and 57% for liver transplant patients,” the authors wrote. “1-year survival was 71% for non-liver transplant patients and dropped off sharply afterward. Survival was significantly improved for liver transplant patients.”

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Of 65 patients with iCCA referred for liver transplantation, the research team transplanted 18 patients, all of whom had a stable, liver-only disease. Patients with previous curative resection attempts were also included.


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All the patients were placed on neoadjuvant therapy including systemic therapy, XRT, and locoregional therapy for 6 months before transplantation. The patients who underwent liver transplantation had a median cumulative tumor size of 10.4 cm, and 10 patients with liver transplantations had more than 1 tumor.

A total of 70% of patients were recurrence-free at 1 year, and 52% at 3 years. There were recurrences in 7 out of 18 patients after liver transplantation. The research team recommends further research into prognostic factors for recurrence and survival after liver transplantation in patients with advanced, unresectable iCCA.

Reference

McMillan R, Kodali S, Javie M, et al. Long term outcomes after liver transplantation for advanced, unresectable intrahepatic cholangiocarcinoma. Poster presented at: Cholangiocarcinoma Foundation Annual Conference: February 23-25, 2022; Salt Lake City, Utah.