Liver Transplantation for Hepatocellular Carcinoma: Prognostic Impact of Complete Pathologic Response and Influence of Treatment Modality

Complete pathologic response (cPR) occurs in approximately one-third of HCC patients undergoing liver transplantation and is strongly associated with improved overall and recurrence-free survival.
Yttrium-90 (Y-90) radioembolization and ablation therapies independently increase cPR rates compared to transarterial chemoembolization (TACE), with Y-90 showing the greatest efficacy especially when administered early within six months of waitlisting.
Imaging-based assessments frequently overestimate treatment response, highlighting the importance of pathological evaluation for accurate prognosis.
Predictors of cPR include lower tumor burden, normal or moderately elevated alpha-fetoprotein (AFP) levels, longer waitlist times, and specific locoregional treatment choice.

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Complete pathologic response (cPR) occurs in approximately one-third of HCC patients undergoing liver transplantation and is strongly associated with improved overall and recurrence-free survival.
Yttrium-90 (Y-90) radioembolization and ablation therapies independently increase cPR rates compared to transarterial chemoembolization (TACE), with Y-90 showing the greatest efficacy especially when administered early within six months of waitlisting.
Imaging-based assessments frequently overestimate treatment response, highlighting the importance of pathological evaluation for accurate prognosis.
Predictors of cPR include lower tumor burden, normal or moderately elevated alpha-fetoprotein (AFP) levels, longer waitlist times, and specific locoregional treatment choice.

Liver Transplantation for Hepatocellular Carcinoma: Prognostic Impact of Complete Pathologic Response and Influence of Treatment Modality—A US National Database Study