Hilar lymph nodes sampling at the time of liver transplantation for hepatocellular carcinoma: to do or not to do?.

Sotiropoulos, Georgios C.; Malagó, Massimo; Molmenti, Ernesto P.; Lösch, Christian; Lang, Hauke; Frilling, Andrea; Broelsch, Christoph E.; Neuhäuser, Markus

doi:10.1111/j.1432-2277.2006.00412.x

Cited by 19 publications

(4 citation statements)

References 60 publications

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“…Significant controversy exists over whether preOLT TACE and postOLT sirolimus‐based immunosuppression have an impact on cancer recurrence and ultimately mortality [11,12,26,27]. Importantly, our experience not only corroborates previous observations underscoring the important contribution of specific pathologic variables [28,29], but fails to show a survival benefit for either preOLT TACE or sirolimus therapy following transplantation. Five‐year survival for those undergoing preOLT chemoembolization is 73%, compared with 63% for those who did not.…”

Section: Discussionsupporting

confidence: 77%

Predictors of long-term outcome following liver transplantation for hepatocellular carcinoma: a single-center experience

Zimmerman¹,

Trotter²,

Wachs³

et al. 2007

Transplant Int

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Summary Orthotopic liver transplantation (OLT) is increasingly being applied for cure in patients with cirrhosis and concomitant hepatocellular carcinoma (HCC). In recipients with limited tumor burden, OLT achieves reasonable long‐term outcome. This study sought to identify clinical and pathologic variables predictive of long‐term disease‐free survival and the presence of vascular invasion. From 1992 to 2006, 130 patients underwent OLT for cirrhosis and HCC. Malignancy was diagnosed in 107 patients prior to OLT and in 23 patients on pathologic examination of the explant. Nine clinical and pathologic variables were considered including: TNM stage, nodularity, vascular invasion, Milan criteria, incidental lesion, differentiation, tumor size, preOLT transarterial chemoembolization (TACE), and administration of sirolimus‐based immunosuppression. The overall incidence of HCC recurrence was 17% with the majority (82%) being stage III. Cumulatively, tumor recurrence‐free survival (RFS) is 84, 74, and 67% at 1, 3, and 5 years respectively. Independent predictors of RFS included stage III and poorly differentiated lesions (P < 0.05). Furthermore, stage III tumors and those >3.5 cm in size were predictive of vascular invasion. Importantly, preOLT, TACE and postOLT sirolimus had no influence on survival. Pathologic variables including tumor stage and grade have a significant impact on outcome. Importantly, it seems that TACE and sirolimus had no beneficial effect.

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Section: Discussionsupporting

confidence: 77%

Predictors of long-term outcome following liver transplantation for hepatocellular carcinoma: a single-center experience

Zimmerman¹,

Trotter²,

Wachs³

et al. 2007

Transplant Int

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“…The management of patients with HCC in cirrhosis constitutes a matter of discussion and disputation among physicians all over the world [30][31][32][33][34][35][36][37]. The great variety of therapeutic options allows on the one side the search for the most convenient/cost effective therapy for each center, but on the other side, emphasizes the loss of the optimal option, which could be available and applicable in most cases [38][39][40][41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Liver Transplantation, Liver Resection, and Transarterial Chemoembolization for Hepatocellular Carcinoma in Cirrhosis: Which Is the Best Oncological Approach?

et al. 2008

Self Cite

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The aim of the study was to evaluate our institutional experience with monotherapies for hepatocellular carcinoma (HCC) in the setting of cirrhosis. A retrospective cohort study was carried out at the tertiary care academic referral center and involved 185 consecutive HCC patients with cirrhosis and no previous treatment who underwent resection (n = 61), transarterial chemoembolization (TACE) (n = 64), or liver transplantation (LT) (n = 60). Long-term survival and survival according to the Milan criteria were the main outcomes measured. Median survival after resection, TACE, and LT was 11, 14, and 23 months, respectively. Five-year cumulative survival after resection, TACE, and LT was 23, 10, and 59%, respectively (P = 0.001). Five-year cumulative disease-free survival after resection and LT was 15% and 77%, respectively (P = 0.002). The presence of complications in the resection group (P = 0.004), MELD score (P = 0.0003), and maximum tumor diameter (P = 0.05) in the TACE group, and tumor grade (P = 0.01) and complications (P = 0.004) in the LT group were found to be independent predictors of survival. Five-year survival for patients within the Milan criteria after resection, TACE, and LT was 26, 37, and 66%, respectively. Five-year survival for patients outside the Milan criteria for patients undergoing LT was 53%. The results suggest that LT represents the best oncological treatment option for patients with HCC in the setting of cirrhosis, even for those beyond the Milan criteria. Considering the scarcity of available organs, liver resection remains the best alternative option. TACE remains a potential therapy in patients within the Milan criteria, where it may be more beneficial than resection.

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“…Besides, lymph node metastasis (LNM), microvascular invasion (MVI), and stage were also identified as important predictors for HCC recurrence and OS. [12][13][14] 2 | MATERIAL AND METHODS…”

Section: Introductionmentioning

confidence: 99%

“…As a result, NANOG and OCT4 coexpression was proved as valuable prognostic signature for recurrence, but not OS for HCC patients after liver transplantation. Besides, lymph node metastasis (LNM), microvascular invasion (MVI), and stage were also identified as important predictors for HCC recurrence and OS …”

Section: Introductionmentioning

confidence: 99%

Prognostic evaluation of NANOG and OCT4 expression for posttransplantation hepatocellular carcinoma recurrence

Cai

Wang

Wei

et al. 2018

J of Cellular Biochemistry

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Postoperative hepatocellular carcinoma (HCC) recurrence and metastasis throw great threaten to its overall survival (OS). This paper focus on exploring the prognostic significance of NANOG and OCT4 expression in HCC recurrence and OS after liver transplantation. Eighty‐six patients who meet University of California San Francisco (UCSF) criteria and underwent liver transplantation in Tianjin First Central Hospital between August 2010 and August 2013 were included. Expression of NANOG and OCT4 was determined by immunohistochemistry. The relationships between NANOG and OCT4 expression with tumor recurrence, tumor count, histology stage, lymph node metastasis (LNM) and microvascular invasion (MVI) were explored through the χ2 test and Cox regression analysis. We found that 19/26 and 20/24 patients with positive expression of NANOG and OCT4 relapsed. Combination of NANOG and OCT4 expression was indicated as valuable prognostic signature for HCC recurrence prediction (P < 0.0011). Besides, we identified other key factors with significant correlations with recurrence, such as LNM (P = 0.011) and MVI (P = 0.024). Strikingly, recurrence sites could significantly affect recurrence time (P = 0.0062) and patients with recurrence in transplanted liver have longer recurrence time. In conclusions, we analyzed the relationships between NANOG/OCT4 expression, clinicopathology features, HCC recurrence, and OS after liver transplantation for the first time. Combination of NANOG, OCT4, LNM, histopathological stage, and MVI may be predictor for HCC recurrence posttransplantation. Comprehensive of histopathological stage grade and LNM were considered as prognosis factor for OS after liver transplantation. This should be helpful for treatment method selection for HCC patients after liver transplantation.

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Hilar lymph nodes sampling at the time of liver transplantation for hepatocellular carcinoma: to do or not to do?.

Cited by 19 publications

References 60 publications

Predictors of long-term outcome following liver transplantation for hepatocellular carcinoma: a single-center experience

Predictors of long-term outcome following liver transplantation for hepatocellular carcinoma: a single-center experience

Liver Transplantation, Liver Resection, and Transarterial Chemoembolization for Hepatocellular Carcinoma in Cirrhosis: Which Is the Best Oncological Approach?

Prognostic evaluation of NANOG and OCT4 expression for posttransplantation hepatocellular carcinoma recurrence

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