Nicola de'Angelis1, Filippo Landi1, Maria Clotilde Carra1, Daniel Azoulay1. 1. Nicola de'Angelis, Filippo Landi, Daniel Azoulay, Unit of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor Hospital, AP-HP, 94010 Créteil, France.
Abstract
AIM: To investigate the efficacy (survival) and safety of treatments for recurrent hepatocellular carcinoma (HCC) in liver transplantation (LT) patients. METHODS: Literature search was performed on available online databases without a time limit until January 2015. Clinical studies describing survival after HCC recurrence in LT patients were retrieved for a full-text evaluation. A total of 61 studies were selected: 13 case reports, 41 retrospective case series, and 7 retrospective comparative studies. RESULTS: Based on all included studies, the mean HCC recurrence rate was 16% of all LTs for HCC. A total of 1021 LT patients experienced HCC recurrence. The median time from LT to HCC recurrence was 13 mo (range 2-132 mo). The majority of patients (67%) presented with HCC extra-hepatic recurrences, involving lung, bone, adrenal gland, peritoneal lymph nodes, and rarely the brain. Overall survival after HCC recurrence was 12.97 mo. Surgical resection of localized HCC recurrence and Sorafenib for controlling systemic spread of HCC recurrence were associated with the higher survival rates (42 and 18 mo, respectively). However, Sorafenib, especially when combined with mTOR, was frequently associated with severe side effects that required dose reduction or discontinuation CONCLUSION: Management of recurrent HCC in LT patients is challenging and associated with poor prognosis independently of the type of treatment.
AIM: To investigate the efficacy (survival) and safety of treatments for recurrent hepatocellular carcinoma (HCC) in liver transplantation (LT) patients. METHODS: Literature search was performed on available online databases without a time limit until January 2015. Clinical studies describing survival after HCC recurrence in LT patients were retrieved for a full-text evaluation. A total of 61 studies were selected: 13 case reports, 41 retrospective case series, and 7 retrospective comparative studies. RESULTS: Based on all included studies, the mean HCC recurrence rate was 16% of all LTs for HCC. A total of 1021 LT patients experienced HCC recurrence. The median time from LT to HCC recurrence was 13 mo (range 2-132 mo). The majority of patients (67%) presented with HCC extra-hepatic recurrences, involving lung, bone, adrenal gland, peritoneal lymph nodes, and rarely the brain. Overall survival after HCC recurrence was 12.97 mo. Surgical resection of localized HCC recurrence and Sorafenib for controlling systemic spread of HCC recurrence were associated with the higher survival rates (42 and 18 mo, respectively). However, Sorafenib, especially when combined with mTOR, was frequently associated with severe side effects that required dose reduction or discontinuation CONCLUSION: Management of recurrent HCC in LT patients is challenging and associated with poor prognosis independently of the type of treatment.
Authors: A Vitale; P Boccagni; X Kertusha; G Zanus; F D'Amico; E Lodo; D Pastorelli; R Ramirez Morales; G Lombardi; M Senzolo; P Burra; U Cillo Journal: Transplant Proc Date: 2012-09 Impact factor: 1.066
Authors: G Sapisochin; N Goldaracena; S Astete; J M Laurence; D Davidson; E Rafael; L Castells; C Sandroussi; I Bilbao; C Dopazo; D R Grant; J L Lázaro; M Caralt; A Ghanekar; I D McGilvray; L Lilly; M S Cattral; M Selzner; R Charco; P D Greig Journal: Ann Surg Oncol Date: 2014-12-04 Impact factor: 5.344
Authors: Iswanto Sucandy; Susannah Cheek; Benjamin J Golas; Allan Tsung; David A Geller; James W Marsh Journal: HPB (Oxford) Date: 2016-07-09 Impact factor: 3.647
Authors: A Bauschke; A Altendorf-Hofmann; H Kissler; A Koch; C Malessa; U Settmacher Journal: J Cancer Res Clin Oncol Date: 2017-08-28 Impact factor: 4.553