Treatment of Hepatocellular Carcinoma With Liver Transplantation: A Single-Center Experience From Brazil

Teixeira, Andreza Corrêa; Mente, Ênio David; Castro‐e‐Silva, Orlando; Sankarankutty, Ajith Kumar; Cantão, Cássio Alfred Brattig; Souza, Fernanda Fernandes; Abud, Daniel Giansante; Muglia, Valdair Francisco; Elias, Jorge; Martinelli, A.L.C.

doi:10.1016/j.transproceed.2010.01.045

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…Individual case-control study C NA -4 [89][90][91][92] Case series (and poor-quality prognostic cohort studies) C 4/125 5 (3-6) 5 [93][94][95][96][97][98] Expert opinion without an explicit critical appraisal, bench research, or first principles D 6/NA NA NOTE: n/n: number of studies/number of patients. NA: not available.…”

Section: Resultsmentioning

confidence: 99%

Milan criteria in liver transplantation for hepatocellular carcinoma: An evidence-based analysis of 15 years of experience

Mazzaferro

Bhoori²,

Sposito³

et al. 2011

Liver Transpl

491

322

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Section: Resultsmentioning

confidence: 99%

Milan criteria in liver transplantation for hepatocellular carcinoma: An evidence-based analysis of 15 years of experience

Mazzaferro

Bhoori²,

Sposito³

et al. 2011

Liver Transpl

491

322

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“…Despite the additional points offered to patients with HCC, the insufficient number of donors still results in waiting times frequently lasting >6 months. In this setting, the risk of drop-out increases; therefore therapeutic procedures such as radiofrequency ablation (RFA), percutaneous ethanol injection (PEI) and transarterial chemoembolization (TACE) have been used to reduce tumour progression while on the waiting list [22].…”

Section: Treatmentmentioning

confidence: 99%

Clinical and Epidemiological Aspects of Hepatocellular Carcinoma in Brazil

Kikuchi

Chagas²,

Alencar³

et al. 2005

Antiviral Therapy

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OBJECTIVES:We performed a national survey to update hepatocellular carcinoma (HCC) epidemiology in Brazil and determined the clinical and epidemiological profiles of patients with HCC in different Brazilian regions. RESULTS:The median age was 59 (1-92 years old; 78% male). At diagnosis, females were older than males (median age: 62 vs. 59 years old respectively; p,0.0001). Ninety-eight percent of the patients had cirrhosis (1279/1308). Hepatitis C virus was the main etiology (54%), followed by hepatitis B virus (16%) and alcohol (14%). In Southeastern and Southern Brazil, hepatitis C virus accounted for over 55% of cases. In the Northeast and North, hepatitis C virus accounted for less than 50%, and hepatitis B virus accounted for 22-25% of cases; hepatitis B was more prevalent in the Northern than in the Southern regions. Some 43%, 35%, and 22% of patients were in early, intermediate, and advanced stages respectively. Initial therapies for HCC included chemoembolization or embolization (36%), percutaneous ablation (13%), liver resection (7%), and sorafenib (1%). Liver transplantation was performed in 242 patients (19%), but it was the initial therapy for only 56 patients (4%). CONCLUSION:The epidemiology, classification, and therapy selection for HCC varied among Brazilian regions. Hepatitis C infection was the most common etiology of liver cirrhosis; chemoembolization was the most common therapy employed. Liver cirrhosis was the main risk factor for HCC development in Brazil.

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Hepatocellular Carcinoma and Other Malignancies in Autoimmune Hepatitis

Czaja

2013

Dig Dis Sci

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Hepatocellular carcinoma and extrahepatic malignancies can complicate the course of autoimmune hepatitis, and these occurrences may increase in frequency as the survival of patients with cirrhosis is extended and the prospect of new nonstandard immune-modifying intervention is realized. The frequency of hepatocellular carcinoma in patients with autoimmune hepatitis and cirrhosis is 1-9 %, and annual occurrence in patients with cirrhosis is 1.1-1.9 %. The standardized incidence ratio for hepatocellular carcinoma in autoimmune hepatitis is 23.3 (95 % confidence interval (CI) 7.5-54.3) in Sweden, and the standardized mortality ratio for hepatobiliary cancer is 42.3 (95 % CI 20.3-77.9) in New Zealand. The principal risk factor is long-standing cirrhosis, and patients at risk are characterized mainly by cirrhosis for ≥ 10 years, manifestations of portal hypertension, persistent liver inflammation, and immunosuppressive therapy for ≥ 3 years. Multiple molecular disturbances, including the accumulation of senescent hepatocytes because of telomere shortening, step-wise accumulation of chromosomal injuries, and aberrations in transcription factors and genes, may contribute to the risk. Extraheptic malignancies of diverse cell types occur in 5 % in an unpredictable fashion. The standardized incidence ratio is 2.7 (95 % CI 1.8-3.9) in New Zealand, and non-melanoma skin cancers are most common. Outcomes are related to the nature and stage of the tumor at diagnosis. Surveillance recommendations have not been promulgated, but hepatic ultrasonography every six months in patients with cirrhosis is a consideration. Routine health screening measures for other malignancies should be applied diligently.

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Treatment of Hepatocellular Carcinoma With Liver Transplantation: A Single-Center Experience From Brazil

Cited by 4 publications

References 10 publications

Milan criteria in liver transplantation for hepatocellular carcinoma: An evidence-based analysis of 15 years of experience

Milan criteria in liver transplantation for hepatocellular carcinoma: An evidence-based analysis of 15 years of experience

Clinical and Epidemiological Aspects of Hepatocellular Carcinoma in Brazil

Hepatocellular Carcinoma and Other Malignancies in Autoimmune Hepatitis

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