Predictors of Long-Term Survival After Liver Transplantation for Hepatocellular Carcinoma

Zavaglia, Claudio; Carlis, Luciano De; Alberti, A.; Minóla, E.; Belli, Luca; Slim, A. O.; Airoldi, Aldo; Giacomoni, Alessandro; Rondinara, G. F.; Tinelli, Carmine; Forti, D; Pinzello, Giovambattista

doi:10.1111/j.1572-0241.2005.00289.x

Cited by 231 publications

(173 citation statements)

References 25 publications

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“…[29][30][31] Macroscopic vascular invasion is also a strong predictor of both survival and tumor recurrence in patients with cirrhosis who received liver transplantation for HCC. 32 The risks of intrahepatic and extrahepatic metastasis were higher for HCC with macroscopic vascular invasion. Meanwhile, multiple tumors may result from multicentric or intrahepatic metastasis.…”

Section: Discussionmentioning

confidence: 99%

Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: Analysis of 5,613 cases from a medical center in southern Taiwan

Kee

Wang

Lee

et al. 2007

Intl Journal of Cancer

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This study was aimed to validate the 5th and 6th editions of tumor-node-metastasis (TNM) system for patients with hepatocellular carcinoma (HCC), and attempted to improve prognostic stratification by modifying the 6th edition according to vascular invasion and tumor size. From 1986 to 2002, a total of 5,613 HCC cases from Kaohsiung Chang Gung Memorial Hospital in southern Taiwan were enrolled. The 6th edition was modified by dividing stage I into stages IA (single tumor, £2cm) and IB (single tumor, >2cm), and by dividing stage II into IIA (multiple tumors, none >5cm) and IIB (tumor with segmental macro vascular invasion). The Akaike information criteria (AIC), within a Cox proportional hazard regression model were used; lower AIC value indicated a better discriminatory ability for staging system. The 1-, 3-, 5-, and 7-year overall survival rates were 45.6, 25.9, 17.9, and 13.4%, respectively. Significant differences in survival curve existed in the 5th, 6th, and modified 6th edition TNM systems. For the modified 6th edition TNM, survival differed significantly between stages IA and IB, and between stage IIA and IIB. The AIC values of 5th (72,328), 6th (72,188), modified 6th (71,991) edition TNM system were decreasing. This investigation demonstrated better prognostic stratifications for the 6th edition than the 5th edition TNM staging system. Moreover, the modified 6th edition staging system demonstrated better prognostic prediction than the former two. Pretreatment staging and simple classification of current modified 6th edition TNM staging can be applied to all HCC patients and are clinically useful. ' 2007 Wiley-Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: Analysis of 5,613 cases from a medical center in southern Taiwan

Kee

Wang

Lee

et al. 2007

Intl Journal of Cancer

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“…Histologic parameters such as vascular invasion and tumor differentiation are the most important indicators of biologic behavior in predicting recurrence [15][16][17]. Nonetheless, these features can only be determined preoperatively with a liver biopsy, which is associated with definite risks and may not yield consistent results.…”

Section: Prognostic Indicators and Selection Criteriamentioning

confidence: 99%

Liver Transplantation for Hepatocellular Carcinoma in Asia

2007

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After completing this course, the reader will be able to:1. Discuss the selection criteria of patients with hepatocellular carcinoma for liver transplantation.2. Describe the problems associated with the application of liver transplantation for hepatocellular carcinoma and the possible solutions.3. Discuss the current status of liver transplantation for hepatocellular carcinoma in Asia.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME With the promotion of organ donation, better quantification of the benefit of LDLT for extended indications, and identification of predictors for survival, the practice of liver transplantation for HCC in Asia will continue to evolve. ABSTRACT

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“…5,6 The 5-year survival in patients transplanted for HCC ranges from 48.2% to 80%. 4,[7][8][9][10] However, HCC recurrence is a rate-limiting event, which clearly affects patient survival. Factors associated with tumor recurrence include tumor burden and vascular invasion.…”

Section: Introductionmentioning

confidence: 99%

Management of Recurrent Hepatocellular Carcinoma in Liver Transplant Recipients: A Systematic Review

Rubin

Ayoub²,

Kaldas³

et al. 2012

Exp Clin Transplant

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Hepatocellular carcinoma is the most common form of liver cancer, representing 70% to 85% of primary hepatic malignancies in adults. Liver transplant is an optimal treatment for patients with hepatocellular carcinoma because it eliminates the malignancy as well as the oftenunderlying liver cirrhosis and restores normal liver function. Since the development of strict selection criteria in hepatocellular carcinoma patients undergoing liver transplant with the implementation of the Milan criteria, patient survival and recurrence rates after liver transplant have dramatically improved. However, several research groups are now seeking to expand this criteria to include more patients with larger tumors who may achieve similar postliver transplant survival rates as those patients meeting current eligibility requirements. Currently, in approximately 20% of patients, hepatocellular carcinoma recurrence is still the rate-limiting event that clearly affects patient survival.Given the limited number of grafts available for transplant, the poor prognosis of untreated hepatocellular carcinoma, and the recent notion of expanding selection criteria, strategies for reducing the rate of, monitoring and treating hepatocellular carcinoma recurrence, in both pretransplants and posttransplants, are explored in this review. We review the available literature to better understand current strategies available to optimize long-term clinical outcomes.

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Predictors of Long-Term Survival After Liver Transplantation for Hepatocellular Carcinoma

Abstract: Histological grade of differentiation and macroscopic vascular invasion, as assessed on the explanted livers, are strong predictors of both survival and tumor recurrence in patients with cirrhosis who received transplants for HCC.

Cited by 231 publications

References 25 publications

Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: Analysis of 5,613 cases from a medical center in southern Taiwan

Validation of clinical AJCC/UICC TNM staging system for hepatocellular carcinoma: Analysis of 5,613 cases from a medical center in southern Taiwan

Liver Transplantation for Hepatocellular Carcinoma in Asia

Management of Recurrent Hepatocellular Carcinoma in Liver Transplant Recipients: A Systematic Review

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