Improved Results of a Surgical Resection for the Recurrence of Hepatocellular Carcinoma After Living Donor Liver Transplantation

Taketomi, Akinobu; Fukuhara, Takasuke; Morita, Kazutoyo; Kuwabara, Hiroto; Ninomiya, Mizuki; Yamashita, Yo‐ichi; Ikegami, Toru; Uchiyama, Hideaki; Yoshizumi, Tomoharu; Soejima, Yuji; Shirabe, Ken; Maehara, Y.

doi:10.1245/s10434-010-0999-y

Cited by 72 publications

(51 citation statements)

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“…In the present study, all patients were under immunosuppression after LT. The immunosuppression might have some effects on prognosis (21) and miRNA expression. Our present study revealed that miR-18a regulates the levels of TNFAIP3 in HCC, which is known to be decreased in HCC and associated with early intrahepatic recurrence after hepatic resection.…”

Section: Discussionmentioning

confidence: 99%

“…(21) The RNA samples from 3 patients who underwent resection of recurrences after LDLT were made available for miRNA microarray analysis. The 3 patients included a man (patient 1) with peritoneal recurrence and infected by hepatitis B virus (HBV), and a woman (patient 2) and a man (patient 3) with lung recurrences and hepatitis C virus (HCV) infection.…”

Section: Microrna Microarray Analysismentioning

confidence: 99%

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Relevance of microRNA‐18a and microRNA‐199a‐5p to hepatocellular carcinoma recurrence after living donor liver transplantation

et al. 2016

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There are few reports about recurrence-related microRNAs (miRNAs) after liver transplantation (LT) for hepatocellular carcinoma (HCC). The purpose of this study was to identify novel recurrence-related miRNAs after living donor liver transplantation (LDLT) for HCC. First, we performed microarray analyses of samples from a liver with primary HCC, a liver that was noncancerous, and a liver that had recurrence-metastasis from 3 patients with posttransplant recurrence. Then we selected miRNAs with consistently altered expression in both primary HCC and recurrence as potential candidates of recurrence-related miRNAs. Expression of the miRNAs in HCC and noncancerous livers was assessed in 70 HCC patients who underwent LDLT. The target genes regulated by the recurrence-related miRNAs were identified. MicroRNA-18a (miR-18a) expression was increased, and microRNA-199a-5p (miR-199a-5p) expression was decreased in both primary HCC and recurrence. Increased miR-18a expression correlated with high levels of tumor markers, large tumor size, and a high recurrence rate. Decreased miR-199a-5p expression correlated with high levels of tumor markers, portal venous invasion, and a high recurrence rate. In HCC cells, miR-18a regulated the expression of tumor necrosis factor alpha-induced protein 3 (TNFAIP3), and miR-199a-5p regulated the expression of hypoxia-inducible factor 1 alpha (HIF1A), vascular endothelial growth factor A (VEGFA), insulin-like growth factor 1 receptor, and insulin-like growth factor 2. In conclusion, increased miR-18a levels and decreased miR-199a-5p levels are relevant to HCC recurrence after LDLT. MiR-18a and miR-199a-5p could be novel therapeutic targets of recurrent HCC after LDLT.Liver Transplantation 22 665-676 2016 AASLD.Received August 31, 2015; accepted December 9, 2015.Hepatocellular carcinoma (HCC) is the most frequent cancer of the liver and the third most common cause of cancer deaths worldwide.(1) Curative treatment is limited to hepatic resection and liver transplantation (LT). However, the overall cumulative recurrence rate after hepatic resection is approximately 80% at 5 years.(2) Among various recurrent patterns of HCC, the prognosis of extrahepatic recurrence-metastasis (M) is much poorer than that of intrahepatic metastasis and multicentric recurrence. (3)(4)(5) LT can overcome the problems of intrahepatic metastasis and multicentric recurrence theoretically. However, the recurrence of HCC after LT is a critical problem to be solved because the outcomes of patients with HCC recurrence after LT are extremely poor. (6) Abbreviations: AFP, alpha-fetoprotein; DCP, des-gamma-carboxyprothrombin; DDLT, deceased donor liver transplantation; HBsAg, hepatitis B surface antigen; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HIF1A, hypoxia-inducible factor 1 alpha; IGF1R, insulin-like growth factor 1 receptor; IGF2, insulin-like growth factor 2; LDLT, living donor liver transplantation; LT, liver transplantation; M, recurrence-metastasis; miR-18a, microRNA-18a; miR-199a-5p, microRNA-199a-5p;...

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Section: Discussionmentioning

confidence: 99%

Section: Microrna Microarray Analysismentioning

confidence: 99%

Relevance of microRNA‐18a and microRNA‐199a‐5p to hepatocellular carcinoma recurrence after living donor liver transplantation

et al. 2016

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“…In fact, the Kyushu University group in 2010 reported 17 patients with HCC recurrence limited to the liver after transplantation; 9 of these patients were treated surgically and experienced survival approximating that of patients who did not experience HCC recurrence. 9 All major series of HCC recurrence have substantiated the better survival of patients treated with resection; there is, however, an obvious case selection bias, so it is impossible to determine the extent to which surgery rather than favorable biology explains the difference. There is indirect evidence for a tumor biology explanation: vascular invasion was found during the original explant pathology examination in only 3 of 7 patients with surgically resectable recurrence but in all 9 patients whose recurrence pattern was unsuitable for surgery in 1 study.…”

Section: Resection/radiofrequency Ablationmentioning

confidence: 99%

Treatment of recurrent hepatocellular carcinoma after liver transplantation

et al. 2011

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“…According to many articles (73)(74)(75)(76)(77)(78), time elapsed since LT and the appearance of recurrence is an important prognostic factor regarding survival, with worst prognosis expected with early HCC recurrence (within 24 months). Early HCC recurrence could be due to non-detectable extra-hepatic spread that was found before performing liver transplantation, and also as a consequence of circulating HCC cell clones engrafting and growing in a target organ in the post-transplant period (79).…”

Section: Local Recurrence After Liver Transplantationmentioning

confidence: 99%

Is There a Place for Resection of HCC in the Presence of Liver Transplantation and Interventional Radiology in Cirrhotic Liver?

Wahab¹,

Wahab²,

Shehta³

et al. 2017

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Hepatocellular carcinoma is the fifth most common cancer worldwide and one of the leading causes of cancer-related mortality. The majority of patients with hepatocellular carcinoma have underlying liver cirrhosis as a result of hepatitis B or hepatitis C virus, and alcoholic hepatitis. Its management in the presence of liver cirrhosis is a complex condition. Selecting the appropriate treatment modality is dependent not only on tumor stage, but also on the severity of the underlying liver disease. Liver resection and transplantation remain the main course of treatment of HCC. However, liver transplantation is considered nowadays the standard of care for hepatocellular carcinoma because it removes both the tumor and the underlying cirrhotic liver; improving quality of life by restoring a normal liver status. However, the shortage of donors and high costs make liver transplantation less available. Therefore, liver resection remains the commonly used strategy for HCC patients with preserved liver functions. However, liver resection is associated with high peri-operative morbidity and mortality, and high incidence of HCC recurrence. Here, we review the role of liver resection in the era of liver transplantation and interventional radiology.

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Improved Results of a Surgical Resection for the Recurrence of Hepatocellular Carcinoma After Living Donor Liver Transplantation

Abstract: Surgical therapy might be useful for patients who experience a recurrence of HCC after LDLT to improve their outcome, when such treatment is available.

Cited by 72 publications

References 25 publications

Relevance of microRNA‐18a and microRNA‐199a‐5p to hepatocellular carcinoma recurrence after living donor liver transplantation

Relevance of microRNA‐18a and microRNA‐199a‐5p to hepatocellular carcinoma recurrence after living donor liver transplantation

Treatment of recurrent hepatocellular carcinoma after liver transplantation

Is There a Place for Resection of HCC in the Presence of Liver Transplantation and Interventional Radiology in Cirrhotic Liver?

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