Efficacy Analysis Of Adjuvant Targeted Drugs For Hepatocellular Carcinoma Patients With High Risk Of Recurrence After Liver Transplantation

Aim:Liver Transplantation（LT）has been recognized as an important method for the treatment of Hepatocellular carcinoma（HCC）,but patients with HCC beyond the Milan-criteria have a high postoperative recurrence rate and short postoperative survival time.Targeted therapies,represented by sorafenib and lenvatinib,have achieved good efficacy in patients with advanced HCC,but their use in the LT population is limited.The purpose of this study was to evaluate the efficacy and safety of sorafenib and lenvatinib preventing recurrence of LT recipients with HCC beyond Milan-criteria.Methods:We retrospectively analyzed 27 patients with HCC beyond Milan-criteria who received liver transplantation in liver transplantation Center of Jilin University,consisting of lenvatinib group（n=9）,sorafenib group（n=9）and control group（n=9）.Recurrence-free survival,recurrence rate and overall survival were compared among the three groups.The safety of drugs was assessed by the incidence of adverse reactions.Results:The median RFS was 598 days in lenvatinib group,169 days in sorafenib group and 144 days in control group.Six patients in lenvatinib group（66.67%）,nine patients in sorafenib group（100.00%）and eight patients in control group（88.89%）had HCC recurrence.The m RFS in lenvatinib group significantly longer than it in control group（x~2=5.729,P<0.05）;There was no significant difference between the sorafenib group and the control group（x~2=0.965,P>0.05）.Patients in the lenvatinib group had a longer OS compared with the control group,and the difference was statistically significant（x~2=8.115,P<0.05）,and there was no significant difference in OS between the sorafenib group and the control group（x~2=3.347,P>0.05）.In the group of lenvatinib,the most common adverse reactions were diarrhea（55.5%）,followed by proteinuria（44.4%）and hypertension（22.2%）.There were 3 patients（33.3%）who had 2 or more adverse reactions at the same time,and there was no drug withdrawal due to intolerance of adverse reactions.Conclusion:Adjuvant lenvaitinib can delay tumor recurrence and prolong overall survival time in patients after LT with HCC beyond Milan-criteria,and the adverse reactions of the drug are tolerable.But adjuvant sorafenib did not improve the prognosis.