Sirolimus improves the prognosis of liver recipients with hepatocellular carcinoma: A single-center experience

Background: Tumor recurrence after liver transplantation (LT) for selective patients diagnosed with hep-atocellular carcinoma (HCC) in the setting of cirrhosis is the greatest challenge effecting the prognosis of these patients. The aim of this study was to evaluate the efficacy of sirolimus on the prognosis for these recipients.Methods: The data from 193 consecutive HCC patients who had undergone LT from January 2015 to December 2019 were retrospectively analyzed. These patients were divided into the sirolimus group [patients took sirolimus combined with calcineurin inhibitors (CNIs) ( n = 125)] and non-sirolimus group [patients took CNI-based therapy without sirolimus ( n = 68)]. Recurrence-free survival (RFS) and overall survival (OS) were compared between the two groups. The prognostic factors and independent risk factors for RFS and OS were further evaluated.Results: Non-sirolimus was an independent risk factor for RFS (HR = 2.990; 95% CI: 1.050-8.470; P = 0.040) and OS (HR = 3.100; 95% CI: 1.190-8.0 0 0; P = 0.020). A higher proportion of patients beyond Hangzhou criteria was divided into the sirolimus group (69.6% vs. 80.9%, P = 0.030). Compared with the non-sirolimus group, the sirolimus group had significantly better RFS ( P < 0.001) and OS ( P < 0.001). Further subgroup analysis showed similar results. Conclusions: This study demonstrated that sirolimus significantly decreased HCC recurrence and pro-longed RFS and OS in LT patients with different stage of HCC.(c) 2022 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.

Automated summary

This study aimed to evaluate the prognosis of liver transplantation patients with hepatocellular carcinoma (HCC) in the setting of cirrhosis. The results showed that the use of sirolimus significantly improved the recurrence-free survival and overall survival compared to non-sirolimus group.