Liver Transplantation for Hepatocellular Carcinoma: Long-Term Results Suggest Excellent Outcomes

Doyle, Majella B.; Vachharajani, Neeta; Maynard, Erin; Shenoy, Surendra; Anderson, Christopher; Wellen, Jason R.; Lowell, Jeffrey A.; Chapman, William C.

doi:10.1016/j.jamcollsurg.2012.02.022

Cited by 46 publications

(36 citation statements)

References 32 publications

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“…Doyle et al . found that HCC+/HCV+ recipients in their cohort did not die from recurrent HCV (3.9%) . However, Moya et al .…”

Section: Discussionmentioning

confidence: 79%

“…However 15 years later, the literature still fails to reach a consensus on the impact of HCV on survival post‐LT in patients with HCC. Some previous studies have demonstrated the independent negative impact of HCV on survival in patients transplanted with HCC whereas others have not . These studies are however limited at 5‐year survival.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hepatitis C infection and hepatocellular carcinoma in liver transplantation: a 20‐year experience

Dumitra

Alabbad

Barkun

et al. 2013

HPB

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“…Doyle et al . found that HCC+/HCV+ recipients in their cohort did not die from recurrent HCV (3.9%) . However, Moya et al .…”

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Hepatitis C infection and hepatocellular carcinoma in liver transplantation: a 20‐year experience

Dumitra

Alabbad

Barkun

et al. 2013

HPB

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“…Li ver transplantation is the best option for radical treatment of early but unresectable hepatocellular carcinoma (HCC), particularly in the setting of liver cirrhosis (1,2). However, HCC recurs after liver transplantation in approximately 20%-30% of patients, and recurrence is difficult to treat and is the rate-limiting factor for long-term survival (3)(4)(5).…”

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confidence: 99%

Prediction of Posttransplantation Recurrence of Hepatocellular Carcinoma Using Metabolic and Volumetric Indices of ¹⁸F-FDG PET/CT

et al. 2016

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18 F-FDG PET is an effective method of predicting recurrence of hepatocellular carcinoma (HCC) after liver transplantation. We compared recently introduced metabolic and volumetric 18 F-FDG PET/ CT indices with the current clinicopathologic predictors for ability to predict recurrence. Methods: In total, 110 HCC patients who underwent 18 F-FDG PET and liver transplantation were enrolled. On PET, SUVs and tumor-to-background ratios (TBRs) were measured as metabolic activity indices. Various metabolic tumor volumes and uptake-volume products (UVP) were also measured as volumetric indices. The ability of these indices and other clinicopathologic factors to predict recurrence was compared. Results: All metabolic and volumetric indices were significant for recurrence prediction on receiver-operating-characteristic curve analyses (P , 0.001). On univariate survival analyses, all PET indices-as well as tumor size, tumor number, the Milan criteria, tumor grade, vascular invasion, and T-stage-were significant factors. However, on multivariate analyses, tumor size, tumor grade, maximum TBR, and UVP calculated by inferior vena cava activity were significant factors (P 5 0.004, 0.014, 0.009, and 0.021, respectively). When the Milan criteria and PET factors were included in the multivariate analysis, the Milan criteria (P 5 0.029), maximum TBR (P , 0.001), and UVP (P 5 0.016) were significant. Conclusion: Volumetric and metabolic activity indices of 18 F-FDG PET are effective predictors of posttransplantation HCC recurrence. In addition to clinicopathologic factors, these indices need to be considered in the selection of candidates for liver transplantation.

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“…Liver cancer is a common malignancy that severely threatens individual health. For early-stage liver cancer patients, hepatectomy, liver transplantation, and radiofrequency ablation therapy all provide high cure rates (Lencioni and Crocetti 2012; Doyle et al 2012; Wedd et al 2015; Forner et al 2012). However, most liver cancer patients in China are already in the middle and late stages of the disease when they seek treatment; therefore, irrespective of whether these patients are treated with hepatectomies or radiofrequency ablation therapy, their recurrence rates of liver cancer are higher than those of patients with early-stage liver cancer.…”

Section: Introductionmentioning

confidence: 99%

Analysis of prognostic factors of more/equal to10 years of survival for liver cancer patients after liver transplantation

Huang

Leng

2018

J Cancer Res Clin Oncol

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ObjectiveTo investigate prognostic factors of more than 10 years of survival for liver cancer patients after liver transplantation.MethodsFrom May 2000 to May 2007, a total of 134 liver cancer patients who underwent liver transplantation in the Department of Hepatobiliary Surgery, Peking University People’s Hospital, were continuously and retrospectively enrolled. The patients included 120 males and 14 females. There were 124 cases (92.5%) of primary hepatocellular carcinoma, 9 cases (6.7%) of cholangiocarcinoma, and 1 case of mixed hepatocellular carcinoma and cholangiocarcinoma. Patients with perioperative death were excluded. Follow-up was performed until May 31st, 2017 or the time of death. According to the data on postoperative survival time, patients were divided into a < 10 years group (81 cases) and a ≥ 10 years group (53 cases). Patients’ clinical data were recorded and analyzed, including alpha-fetoprotein (AFP) level (≥ 400 µg/L or < 400 µg/L), number of tumor lesions (< 3 or ≥ 3), tumor size (≤ 5 cm or > 5 cm), vascular tumor thrombus (large blood vessel or non-large blood vessel), and histological differentiation degree. The Kaplan–Meier method was used to calculate survival rates. The log-rank method was used to compare the differences between survival curves. The Cox proportional hazards regression model was used to perform multivariate analyses of possibly influential factors.Results(1) Follow-up was conducted with all 134 liver cancer patients after liver transplantation. The follow-up periods were 1–201 months, with a median of 18 (8.75, 132.5) months. The Kaplan–Meier survival analysis results showed that the 1-year, 3-year, 5-year, and 10-year cumulative survival rates were 70.3%, 48.6%, 46.8%, and 46.8%, respectively. (2) The differences in the age of patients, the incidence rate of AFP ≥ 400 µg/L, tumor histological differentiation, vascular tumor thrombi, tumor lesion size, and number of tumor lesions between two groups were all statistically significant (all P < 0.01). (3) The cumulative survival rates were different in AFP (log-rank χ2 = 13.428), histopathologic differentiation (log-rank χ2 = 33.592), large blood vessel tumor thrombi (log-rank χ2 = 36.470), tumor lesion size (log-rank χ2 = 39.835), and number of tumor lesions (log-rank χ2 = 47.016), and there were statistically significant differences between groups (all P < 0.01). (4) Multivariate Cox proportional hazards regression analyses showed that ≥ 3 tumor lesions [hazard ratio (HR) = 2.879, 95% confidence interval (CI) 1.566–5.422], tumor lesion size > 5 cm (HR = 2.682, 95% CI 1.382–5.366), large blood vessel tumor thrombi (HR = 1.831, 95% CI 1.010–3.341), and poor histological differentiation (HR = 2.150, 95% CI 1.372–3.394), were risk factors affecting the 10-year survival of liver cancer patients after liver transplantation (all P < 0.05).ConclusionTumor size, tumor number, large blood vessel tumor thrombi, and low tumor differentiation were all found to be independent risk factors affecting the 10-year survival rate after li...

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Liver Transplantation for Hepatocellular Carcinoma: Long-Term Results Suggest Excellent Outcomes

Cited by 46 publications

References 32 publications

Hepatitis C infection and hepatocellular carcinoma in liver transplantation: a 20‐year experience

Hepatitis C infection and hepatocellular carcinoma in liver transplantation: a 20‐year experience

Prediction of Posttransplantation Recurrence of Hepatocellular Carcinoma Using Metabolic and Volumetric Indices of ¹⁸F-FDG PET/CT

Analysis of prognostic factors of more/equal to10 years of survival for liver cancer patients after liver transplantation

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Liver Transplantation for Hepatocellular Carcinoma: Long-Term Results Suggest Excellent Outcomes

Cited by 46 publications

References 32 publications

Hepatitis C infection and hepatocellular carcinoma in liver transplantation: a 20‐year experience

Hepatitis C infection and hepatocellular carcinoma in liver transplantation: a 20‐year experience

Prediction of Posttransplantation Recurrence of Hepatocellular Carcinoma Using Metabolic and Volumetric Indices of 18F-FDG PET/CT

Analysis of prognostic factors of more/equal to10 years of survival for liver cancer patients after liver transplantation

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Prediction of Posttransplantation Recurrence of Hepatocellular Carcinoma Using Metabolic and Volumetric Indices of ¹⁸F-FDG PET/CT