Excellent survival rates for liver cancer patients undergoing transplant

More than 60 percent of liver transplant patients with advanced liver cancer are still alive after five years, compared to nearly zero survival for those patients who did not undergo transplant, according to a study by Johns Hopkins researchers.

“This is good news for patients with liver cancer. If diagnosed early, transplantation is the treatment of choice for patients with liver cancer and advanced cirrhosis,” says Paul Thuluvath, M.D., associate professor of medicine at Johns Hopkins and lead author of the report published in the Dec. 1, issue of the Journal of Clinical Oncology and available online after Oct. 27.

Thuluvath emphasizes that regular screening of patients with cirrhosis, a risk factor for liver cancer, is needed to detect the cancer early and insure the best possible outcome.

In addition to the favorable five-year survival rates, Thuluvath and colleagues found that survival rates increased steadily over the last decade, suggesting that criteria for patient selection established by other experts may assist physicians in selecting those patients most likely to respond well to the procedure.

Using the United Network for Organ Sharing (UNOS) database, the researchers collected data on 48,887 patients who underwent liver transplantation in the United States between 1987 and 2001. Patients were excluded if they had undergone multiple organ transplantation or retransplantation, were less than 18 years of age, or lacked survival data.

Of the remaining patients included in the final analysis, 985 had liver transplantation for liver cancer and 33,339 patients had liver transplantation for other reasons (control group). Both the liver cancer and control groups were divided into three different five-year time periods: 1987 – 1991, 1992 – 1996, and 1997 – 2001.

Researchers found significant and steady improvement in survival over time among liver transplant patients with liver cancer, especially in the last five years. Five-year survival improved from 25.3 percent during 1987-1991 to 47 percent during 1992-1996, and 61.1 percent during 1996-2001.

According to the Johns Hopkins Gastroenterology and Hepatology Resource Center, liver cancer, also called hepatocellular carcinoma or hepatoma, is one of the most common cancers in adults, with more than 1 million new cases diagnosed each year. It is twice as common in men as in women.

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Other authors are Hwan Y. Yoo, Cary H. Patt, and Jean-Francois Geschwind, all from Johns Hopkins. The research was supported by AASLD/Schering Advanced Hepatocellular Carcinoma Fellowship Award.