Due to a limited number of recurrences in each group, a multivariate analysis could not be performed separately for the two groups. Because the pattern of recurrence in both groups was similar, multivariate analysis was performed Vemurafenib clinical trial on the whole patient cohort (combining the 2 groups) to identify independent risk factors for recurrence. A chi-square test was used to compare categorical data; a Student t test was used to compare contiguous variables. Recurrence and survival probabilities were calculated
using the Kaplan-Meier method and were compared with a log-rank test. P < 0.05 was considered statistically significant. All statistical analyses were performed using SPSS version 13.0 (SPSS Inc., Chicago, IL). Table 1 compares the characteristics of the 183 patients with HCC (according to histology or BCLC criteria) who were listed for LDLT (36 cases) and DDLT (147 cases) and those who were finally transplanted (36 LDLT and 120 DDLT, respectively). The two groups were similar for patient demographics and tumor characteristics.
The dropout rate for patients listed for LDLT was 0%, whereas 27 (18.4%) patients dropped out from the DDLT list (P = 0.01). The median time from listing to dropout in these patients was 9 months. Tumor progression (i.e., tumoral vascular thrombosis and/or tumor metastases) was the main cause of dropout (19/27 [70%]) in our series. Cell Cycle inhibitor Thirty-six patients (100% of those listed) underwent LDLT, and 120 patients (81.6% of those listed) underwent DDLT. The waiting medchemexpress time for the LDLT group (2.6 ± 2.4 months) was significantly shorter compared with the DDLT group (7.9 ± 9 months; P = 0.001). Three patients in the LDLT group and 4 patients in the DDLT group did not have any proof of HCC on the explanted liver. These patients were excluded when the recurrence rate and OS posttransplantation were calculated. Nine patients died during the postoperative period. There were three postoperative deaths in the LDLT
group compared with 6 postoperative deaths in the DDLT group (8% versus 5%; P = 0.45). None of the deaths were tumor-related. The median delay to postoperative death overall was 0.82 months (range, 0.03-9.9 months); the delay was similar in the two groups (DDLT, 0.59 months; LDLT, 0.82 months). The mean follow-up was 58 ± 37 months for the LDLT group and 50 ± 31 months for the DDLT group (P = 0.23). None of the patients in our study received immunosuppression with rapamicin post-LT. Eighteen patients out of 141 survivors after transplantation with a proven HCC on the explanted specimen developed tumor recurrence: 14 out of 110 (12.7%) patients in the DDLT group, 4 out of 31 (12.9%) patients in the LDLT group (P = 0.78). The rate of recurrence of HCC post-LT in the two groups (LDLT versus DDLT) is shown in Fig. 1. A trend toward longer time to recurrence after LDLT (38 ± 27 months, range 14-77 months) compared with DDLT (16 ± 13 months; range, 2-47 months) was observed.