Z Gastroenterol 2018; 56(01): E2-E89
DOI: 10.1055/s-0037-1612800
Poster Visit Session IV Tumors, Liver Surgery and Transplantation – Saturday, January 27, 2018, 8:30am – 9:15am, Foyer area West Wing
Georg Thieme Verlag KG Stuttgart · New York

Evolutionary distance predicts recurrence after liver transplantation in multifocal hepatocellular carcinoma

N Heits
1   University Hospital Schleswig-Holstein, Campus Kiel, Department of General, Visceral-, Thoracic-, Transplantation- and Pediatric Surgery, Kiel
,
M Brosch
2   University Hospital Dresden, TU Dresden, Medical Department 1, Dresden
,
A Herrmann
2   University Hospital Dresden, TU Dresden, Medical Department 1, Dresden
,
R Behrens
1   University Hospital Schleswig-Holstein, Campus Kiel, Department of General, Visceral-, Thoracic-, Transplantation- and Pediatric Surgery, Kiel
,
C Röcken
3   University Hospital Schleswig-Holstein, Campus Kiel, Institute for Pathology, Kiel
,
H Schrem
4   Hannover Medical School, Department of General, Visceral and Transplant Surgery, Hannover
5   Hannover Medical School, Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research Treatment Center – Transplantation (IFB-Tx), Hannover
,
A Kaltenborn
5   Hannover Medical School, Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research Treatment Center – Transplantation (IFB-Tx), Hannover
6   Federal Armed Forces Hospital Westerstede, Department of Trauma and Orthopaedic Surgery, Westerstede
,
J Klempnauer
4   Hannover Medical School, Department of General, Visceral and Transplant Surgery, Hannover
,
H Kreipe
7   Hannover Medical School, Institute of Pathology, Hannover
,
B Reichert
1   University Hospital Schleswig-Holstein, Campus Kiel, Department of General, Visceral-, Thoracic-, Transplantation- and Pediatric Surgery, Kiel
,
C Lenschow
8   University Hospital of Muenster, Department of General Surgery and Visceral Surgery,, Muenster
,
C Wilms
9   University Hospital of Muenster, Clinic for Transplantation Medicine, Muenster
,
H Wolters
8   University Hospital of Muenster, Department of General Surgery and Visceral Surgery,, Muenster
10   St. Josefs Hospital Dortmund-Hoerde, Department for Visceral and General Surgery, Dortmund
,
E Wardelmann
11   University Hospital of Muenster, Department of Pathology, Muenster
,
D Seehofer
12   Charité – Universitätsmedizin Berlin, Department of Surgery, Campus Charité Mitte | Campus Virchow-Klinikum, Berlin
,
S Buch
2   University Hospital Dresden, TU Dresden, Medical Department 1, Dresden
,
S Zeissig
2   University Hospital Dresden, TU Dresden, Medical Department 1, Dresden
,
S Pannach
2   University Hospital Dresden, TU Dresden, Medical Department 1, Dresden
,
N Raschzok
12   Charité – Universitätsmedizin Berlin, Department of Surgery, Campus Charité Mitte | Campus Virchow-Klinikum, Berlin
,
M Dietel
13   Charité University Hospital, Institute of Pathology, Berlin
,
W von Schoenfels
1   University Hospital Schleswig-Holstein, Campus Kiel, Department of General, Visceral-, Thoracic-, Transplantation- and Pediatric Surgery, Kiel
,
S Hinz
1   University Hospital Schleswig-Holstein, Campus Kiel, Department of General, Visceral-, Thoracic-, Transplantation- and Pediatric Surgery, Kiel
,
A Teufel
14   University Hospital Regensburg, Department of Medicine, Regensburg
,
M Evert
15   University of Regensburg, Institute of Pathology, Regensburg
,
A Franke
16   University Hospital Schleswig-Holstein, Campus Kiel, Institute for Clinical Molecular Biology, Kiel
,
T Becker
1   University Hospital Schleswig-Holstein, Campus Kiel, Department of General, Visceral-, Thoracic-, Transplantation- and Pediatric Surgery, Kiel
,
F Braun
1   University Hospital Schleswig-Holstein, Campus Kiel, Department of General, Visceral-, Thoracic-, Transplantation- and Pediatric Surgery, Kiel
,
J Hampe
2   University Hospital Dresden, TU Dresden, Medical Department 1, Dresden
,
C Schafmayer
1   University Hospital Schleswig-Holstein, Campus Kiel, Department of General, Visceral-, Thoracic-, Transplantation- and Pediatric Surgery, Kiel
› Author Affiliations
Further Information

Publication History

Publication Date:
03 January 2018 (online)

Also available at
 

Question:

Liver transplantation (LTx) is a potentially curative treatment option for hepatocellular carcinoma in cirrhosis as it treats both the tumour and the underlying premalignant condition. However, patients where HCC is already a systemic disease, LTx may be individually harmful and has a negative impact on donor organ usage. There is thus a need for improved selection criteria beyond nodule morphology to select patients with a favourable outcome for LTx in multifocal HCC. Evolutionary distance measured from genome-wide SNP data between tumour nodules and the cirrhotic liver may be a predictor of survival after liver transplantation for multifocal HCC.

Methods:

In a retrospective multicentre study, clinical data and formalin fixed paraffin embedded (FFPE) specimens of the liver and two tumor nodules were obtained from explants of 30 patients in the discovery and 180 patients in the replication cohort. DNA was extracted from FFPE specimens followed by genome wide SNP genotyping.

Results:

Genotype quality criteria allowed the analysis of 8 patients in the discovery and 17 patients DNA concentrations of a total of 25 patients fulfilled the quality criteria and were included in the analysis. Both in the discovery (p = 0.04) and in the replication datasets (p = 0.01), evolutionary distance was associated with the risk of recurrence of HCC after transplantation (combined p = 0.0002). In a post-hoc Cox regression analysis, evolutionary distance (p = 7.4 × 10 – 6), microvascular invasion (p = 1.31 × 10 – 5) captured the survival information in a multivariate model.

Conclusions:

Evolutionary distance allows the definition of a high-risk group of recurrence if preoperative liver biopsy is considered.