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Article: Recurrence of hepatocellular cancer after liver transplantation: The role of primary resection and salvage transplantation in East and West

TitleRecurrence of hepatocellular cancer after liver transplantation: The role of primary resection and salvage transplantation in East and West
Authors
KeywordsHbv
Hcv
Hepatocellular Cancer
Liver Transplantation
Living Donation
Salvage Transplantation
Tumor Recurrence
Issue Date2012
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
Citation
Journal Of Hepatology, 2012, v. 57 n. 5, p. 974-979 How to Cite?
AbstractBackground & Aims: Greater tumor aggressiveness and different management modalities of hepatocellular cancer (HCC) before liver transplantation (LT) may explain the higher recurrence rates reported in Asia. This study investigates the prognostic factors for HCC recurrence in a Western and an Eastern HCC patient cohort in order to analyze the respective roles of tumor- and management-related factors on the incidence of post-LT HCC recurrence. Methods: Data of 273 HCC patients, transplanted during the period January 1999-March 2009, were obtained from the Rome Inter-University Liver Transplant Consortium (n = 157) and Hong Kong University (n = 116) databases. Median follow-up was 4.3 years (range: 0.2-12). Recurrence rate and multivariate logistic regression analysis was performed on the entire population and on Milan criteria-in (MC-in) patients. Results: Multivariate analysis on the entire population identified four independent risk factors for post-LT HCC recurrence: microvascular invasion (odds ratio, OR = 4.88; p = 0.001), poor tumor grading (OR = 6.86; p = 0.002), diameter of the largest tumor (OR = 4.72; p = 0.05), and previous liver resection (LR) (OR = 3.34; p = 0.04). After removal of LR, only tumor-related variables were independent risk factors for recurrence. When only MC-in patients were analyzed, no difference was observed between the two cohorts in terms of recurrence rate after LR patient removal. Conclusions: LR followed by salvage "for HCC recurrence" LT represents the main reason for a higher HCC recurrence rate in the Hong Kong patients, but not LR followed by salvage "for liver failure" LT in the Roman group. This approach towards HCC before LT may not be universally applicable. The precise patient background must be taken into account in order to identify the best pre-LT strategy. © 2012 European Association for the Study of the Liver.
Persistent Identifierhttp://hdl.handle.net/10722/173039
ISSN
2015 Impact Factor: 10.59
2015 SCImago Journal Rankings: 4.570

 

DC FieldValueLanguage
dc.contributor.authorLai, Qen_US
dc.contributor.authorAvolio, AWen_US
dc.contributor.authorLerut, Jen_US
dc.contributor.authorSingh, Gen_US
dc.contributor.authorChan, SCen_US
dc.contributor.authorBerloco, PBen_US
dc.contributor.authorTisone, Gen_US
dc.contributor.authorAgnes, Sen_US
dc.contributor.authorChok, KSHen_US
dc.contributor.authorSharr, Wen_US
dc.contributor.authorRossi, Men_US
dc.contributor.authorManzia, TMen_US
dc.contributor.authorLo, CMen_US
dc.date.accessioned2012-10-30T06:26:53Z-
dc.date.available2012-10-30T06:26:53Z-
dc.date.issued2012en_US
dc.identifier.citationJournal Of Hepatology, 2012, v. 57 n. 5, p. 974-979en_US
dc.identifier.issn0168-8278en_US
dc.identifier.urihttp://hdl.handle.net/10722/173039-
dc.description.abstractBackground & Aims: Greater tumor aggressiveness and different management modalities of hepatocellular cancer (HCC) before liver transplantation (LT) may explain the higher recurrence rates reported in Asia. This study investigates the prognostic factors for HCC recurrence in a Western and an Eastern HCC patient cohort in order to analyze the respective roles of tumor- and management-related factors on the incidence of post-LT HCC recurrence. Methods: Data of 273 HCC patients, transplanted during the period January 1999-March 2009, were obtained from the Rome Inter-University Liver Transplant Consortium (n = 157) and Hong Kong University (n = 116) databases. Median follow-up was 4.3 years (range: 0.2-12). Recurrence rate and multivariate logistic regression analysis was performed on the entire population and on Milan criteria-in (MC-in) patients. Results: Multivariate analysis on the entire population identified four independent risk factors for post-LT HCC recurrence: microvascular invasion (odds ratio, OR = 4.88; p = 0.001), poor tumor grading (OR = 6.86; p = 0.002), diameter of the largest tumor (OR = 4.72; p = 0.05), and previous liver resection (LR) (OR = 3.34; p = 0.04). After removal of LR, only tumor-related variables were independent risk factors for recurrence. When only MC-in patients were analyzed, no difference was observed between the two cohorts in terms of recurrence rate after LR patient removal. Conclusions: LR followed by salvage "for HCC recurrence" LT represents the main reason for a higher HCC recurrence rate in the Hong Kong patients, but not LR followed by salvage "for liver failure" LT in the Roman group. This approach towards HCC before LT may not be universally applicable. The precise patient background must be taken into account in order to identify the best pre-LT strategy. © 2012 European Association for the Study of the Liver.en_US
dc.languageengen_US
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhepen_US
dc.relation.ispartofJournal of Hepatologyen_US
dc.subjectHbven_US
dc.subjectHcven_US
dc.subjectHepatocellular Canceren_US
dc.subjectLiver Transplantationen_US
dc.subjectLiving Donationen_US
dc.subjectSalvage Transplantationen_US
dc.subjectTumor Recurrenceen_US
dc.titleRecurrence of hepatocellular cancer after liver transplantation: The role of primary resection and salvage transplantation in East and Westen_US
dc.typeArticleen_US
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_US
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_US
dc.identifier.authorityChan, SC=rp01568en_US
dc.identifier.authorityLo, CM=rp00412en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.jhep.2012.06.033en_US
dc.identifier.pmid22771712-
dc.identifier.scopuseid_2-s2.0-84867574795en_US
dc.identifier.hkuros213824-
dc.publisher.placeNetherlandsen_US
dc.identifier.scopusauthoridLai, Q=25822653100en_US
dc.identifier.scopusauthoridAvolio, AW=7006686265en_US
dc.identifier.scopusauthoridLerut, J=7006381905en_US
dc.identifier.scopusauthoridSingh, G=7404168073en_US
dc.identifier.scopusauthoridChan, SC=7404255575en_US
dc.identifier.scopusauthoridBerloco, PB=7005248713en_US
dc.identifier.scopusauthoridTisone, G=7006469247en_US
dc.identifier.scopusauthoridAgnes, S=7004543561en_US
dc.identifier.scopusauthoridChok, KS=6508229426en_US
dc.identifier.scopusauthoridSharr, W=36864499000en_US
dc.identifier.scopusauthoridRossi, M=7403709038en_US
dc.identifier.scopusauthoridManzia, TM=12778320600en_US
dc.identifier.scopusauthoridLo, CM=7401771672en_US
dc.identifier.citeulike10866232-

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