Liver transplantation and vascular tumours

Bonaccorsi‐Riani, Eliano; Lerut, Jan

doi:10.1111/j.1432-2277.2010.01107.x

Cited by 28 publications

(24 citation statements)

References 24 publications

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“…At our center, all 3 children with embryonal sarcoma and 1 with rhabdoid sarcoma are alive and disease‐free 5 years after LT, corroborating multicenter results (Table ). The only mortality was a child transplanted for angiosarcoma of the liver, for which the prognosis remains poor historically . Survival after LT for metastatic neuroendocrine tumors was similarly excellent.…”

Section: Discussionmentioning

confidence: 99%

Pediatric liver transplantation for hepatocellular cancer and rare liver malignancies: US multicenter and single‐center experience (1981‐2015)

et al. 2017

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A tenth of all pediatric liver transplantations (LTs) are performed for unresectable liver malignancies, especially the more common hepatoblastoma (HBL). Less understood are outcomes after LT for the rare hepatocellular carcinoma, nonhepatoblastoma embryonal tumors (EMBs), and slow growing metastatic neuroendocrine tumors of childhood. Pediatric LT is increasingly performed for rare unresectable liver malignancies other than HBL. We performed a retrospective review of outcomes after LT for malignancy in the multicenter US Scientific Registry of Transplant Recipients (SRTR; n = 677; 1987‐2015). We then reviewed the Children's Hospital of Pittsburgh (CHP; n = 74; 1981‐2014) experience focusing on LT for unresectable hepatocellular cancer (HCC), EMBs, and metastatic liver tumors (METS). HBL was included to provide reference statistics. In the SRTR database, LT for HCC and HBL increased over time (P < 0.001). Compared with other malignancies, the 149 HCC cases received fewer segmental grafts (P < 0.001) and also experienced 10‐year patient survival similar to 15,710 adult HCC LT recipients (51.6% versus 49.6%; P = 0.848, not significant [NS], log‐rank test). For 22 of 149 cases with incidental HCC, 10‐year patient survival was higher than 127 primary HCC cases (85% [95% confidence interval (CI), 70.6%‐100%] versus 48.3% [95% CI, 38%‐61%]; P = 0.168, NS) and similar to 3392 biliary atresia cases (89.9%; 95% CI, 88.7%‐91%). Actuarial 10‐year patient survival for 17 EMBs, 10 METS, and 6 leiomyosarcoma patients exceeded 60%. These survival outcomes were similar to those seen for HBL. At CHP, posttransplant recurrence‐free and overall survival among 25 HCC, 17 (68%) of whom had preexisting liver disease, was 16/25 or 64%, and 9/25 or 36%, respectively. All 10 patients with incidental HCC and tumor‐node‐metastasis stage I and II HCC survived recurrence‐free. Only vascular invasion predicted poor survival in multivariate analysis (P < 0.0001). A total of 4 of 5 EMB patients (80%) and all patients with METS (neuroendocrine‐2, pseudopapillary pancreatic‐1) also survived recurrence‐free. Among children, LT can be curative for unresectable HCC confined to the liver and without vascular invasion, incidental HCC, embryonal tumors, and metastatic neuroendocrine tumors. Liver Transplantation 23 1577–1588 2017 AASLD.

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Section: Discussionmentioning

confidence: 99%

Pediatric liver transplantation for hepatocellular cancer and rare liver malignancies: US multicenter and single‐center experience (1981‐2015)

et al. 2017

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“…Liver transplant has also been abandoned because of high recurrence rate and poor posttransplant survival . According to European Liver Transplant Registry experience, PHA is an absolute contraindication to liver transplant; the median overall survival of 22 patients who underwent liver transplant is 6 months, five (23%) patients died of infectious complications and 17 (77%) patients died of tumor recurrence . It is a disappointing outcome for the limited organ resource.…”

Section: Treatment Of Phamentioning

confidence: 99%

“…50 According to European Liver Transplant Registry experience, PHA is an absolute contraindication to liver transplant; the median overall survival of 22 patients who underwent liver transplant is 6 months, five (23%) patients died of infectious complications and 17 (77%) patients died of tumor recurrence. 50,51 It is a disappointing outcome for the limited organ resource. Maluf et al thought that the possibility of diffuse liver lesions (hepatocellular carcinoma, angiosarcoma, etc.)…”

Section: Treatment Of Phamentioning

confidence: 99%

Primary hepatic angiosarcoma and potential treatment options

Zheng

Zhang

et al. 2014

J of Gastro and Hepatol

117

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Angiosarcomas account for a mere 2-3% of adult soft tissue sarcomas, with an overall poor outcome. Depending on the primary site, angiosarcomas have distinct prognosis. Primary hepatic angiosarcomas (PHAs) are much rare tumors, with worse prognosis compared with other angiosarcomas. PHA is reported to be associated with vinyl chloride, but the majority of patients were still with unknown etiology. As PHA lacks specific symptoms, signs, or images, pathological diagnosis is necessary. The review summarizes 25 articles published from January 2000 to December 2012, including 64 cases of PHA with detailed information. Survival curves are estimated using the Kaplan-Meier method by SPSS 21.0. We find that the median survival time is 5 months; local excision alone or combination with adjuvant therapy is the optimal choice, with median survival time of 17 months. In addition, liver transplant is abandoned for high recurrence rate; emergent transcatheter arterial embolization is thought to be an efficient method for controlling intra-abdominal bleeding; and transcatheter arterial chemoembolization and chemotherapy may be helpful in improving survival.

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“…Our experience is that surgical excision improves local PFS compared to active surveillance when disease burden is assessed, but distal PFS is similar. A number of retrospective studies have reported the outcome of EHE patients treated with liver transplantation (LT) (6)(7)(8). These studies are limited by an inherent selection bias and their retrospective nature.…”

Section: Discussionmentioning

confidence: 99%