TY - JOUR
T1 - The Role of Immunosuppression for Recurrent Cholangiocellular Carcinoma after Liver Transplantation
AU - Gül-Klein, Safak
AU - Schmitz, Paulina
AU - Schöning, Wenzel
AU - Öllinger, Robert
AU - Lurje, Georg
AU - Jonas, Sven
AU - Uluk, Deniz
AU - Pelzer, Uwe
AU - Tacke, Frank
AU - Schmelzle, Moritz
AU - Pratschke, Johann
AU - Saidy, Ramin Raul Ossami
AU - Eurich, Dennis
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - Liver transplantation (LT) for cholangiocarcinoma (CCA), or biliary tract cancer (BTC), remains controversial regarding high recurrence rates and poor prognosis. Oncological follow-up may benefit from tumor-inhibiting properties of mTOR inhibitors (mTORI), shown with improved survival for recurrent hepatocellular carcinoma (HCC) patients after LT. The aim of this study was to investigate the recurrence and survival in relation to tumor type and type of immunosuppression (IS). LT patients with CCA or mixed HCC/CCA (mHCC/CCA) (n = 67) were retrospectively analyzed. Endpoints were the time from LT to recurrence (n = 44) and survival after recurrence. Statistically significant impairment in survival for recurrent CCA (rCCA) was shown in patients not eligible for surgical resection (HR 2.46 (CI: 1.2–5.1; p = 0.02). Histological proven grading >1 and N1 status at initial transplantation were associated with impaired survival (HR 0.13 (CI: 0.03–0.58); p < 0.01 and HR 3.4 (CI: 1.0–11.65); p = 0.05). Reduced IS after tumor recurrence improved survival (HR 4.2/CI: 1.3–13.6; p = 0.02). MTORI initiation before recurrence or after had no significant impact on survival. Our data thereby indicate, similar to findings in recurrent HCC after LT, that patients with rCCA after LT benefit from a reduction in IS upon recurrence.
AB - Liver transplantation (LT) for cholangiocarcinoma (CCA), or biliary tract cancer (BTC), remains controversial regarding high recurrence rates and poor prognosis. Oncological follow-up may benefit from tumor-inhibiting properties of mTOR inhibitors (mTORI), shown with improved survival for recurrent hepatocellular carcinoma (HCC) patients after LT. The aim of this study was to investigate the recurrence and survival in relation to tumor type and type of immunosuppression (IS). LT patients with CCA or mixed HCC/CCA (mHCC/CCA) (n = 67) were retrospectively analyzed. Endpoints were the time from LT to recurrence (n = 44) and survival after recurrence. Statistically significant impairment in survival for recurrent CCA (rCCA) was shown in patients not eligible for surgical resection (HR 2.46 (CI: 1.2–5.1; p = 0.02). Histological proven grading >1 and N1 status at initial transplantation were associated with impaired survival (HR 0.13 (CI: 0.03–0.58); p < 0.01 and HR 3.4 (CI: 1.0–11.65); p = 0.05). Reduced IS after tumor recurrence improved survival (HR 4.2/CI: 1.3–13.6; p = 0.02). MTORI initiation before recurrence or after had no significant impact on survival. Our data thereby indicate, similar to findings in recurrent HCC after LT, that patients with rCCA after LT benefit from a reduction in IS upon recurrence.
KW - cholangiocellular carcinoma
KW - liver transplantation
KW - recurrent cholangiocellular carcinoma
KW - reduced immunosuppression
UR - https://www.scopus.com/pages/publications/85131587851
U2 - 10.3390/cancers14122890
DO - 10.3390/cancers14122890
M3 - Article
AN - SCOPUS:85131587851
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 12
M1 - 2890
ER -