Factors Affecting Recurrence and Survival After Liver Transplantation for Hepatocellular Carcinoma

Yilmaz, Cahit; Karaca, Cezmi; Iakobadze, Zaza; Farajov, Rasim; Kılıç, Koray; Doğanay, Latife; Kılıç, Murat

doi:10.1016/j.transproceed.2018.05.027

Cited by 10 publications

(10 citation statements)

References 23 publications

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“…Variable parameters such as serum AFP level, des-gamma-carboxy prothrombin level, tumor size and number, margin status, major vessel invasion, tumor stage, Edmonson-Steiner grade, Child-Pugh score, portal hypertension and cirrhosis, are considered clinical prognosticators of HCC, depending on the treatment modalities and underling liver diseases[28-32]. Pathologically, the overall poor outcome of HCCs expressing stem cell markers such as keratin 19 (K19), epithelial cell adhesion molecule (EpCAM), and CD133 has been reported, potentially via hypoxia-induced epithelial to mesenchymal transition[33-36].…”

Section: Pathologic Prognostic Biomarkersmentioning

confidence: 99%

Update on hepatocellular carcinoma: Pathologists’ review

Jabbour

Lagana

Lee

2019

WJG

121

102

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Histopathologic diversity and several distinct histologic subtypes of hepatocellular carcinoma (HCC) are well-recognized. Recent advances in molecular pathology and growing knowledge about the biology associated with distinct histologic features and immuno-profile in HCC allowed pathologists to update classifications. Improving sub-classification will allow for more clinically relevant diagnoses and may allow for stratification into biologically meaningful subgroups. Therefore, immuno-histochemical and molecular testing are not only diagnostically useful, but also are being incorporated as crucial components in predicting prognosis of the patients with HCC. Possibilities of targeted therapy are being explored in HCC, and it will be important for pathologists to provide any data that may be valuable from a theranostic perspective. Herein, we review and provide updates regarding the pathologic sub-classification of HCC. Pathologic diagnostic approach and the role of biomarkers as prognosticators are reviewed. Further, the histopathology of four particular subtypes of HCC: Steatohepatitic, clear cell, fibrolamellar and scirrhous - and their clinical relevance, and the recent consensus on combined HCC-cholangiocarcinoma is summarized. Finally, emerging novel biomarkers and new approaches to HCC stratification are reviewed.

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Section: Pathologic Prognostic Biomarkersmentioning

confidence: 99%

Update on hepatocellular carcinoma: Pathologists’ review

Jabbour

Lagana

Lee

2019

WJG

121

102

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“…The pathological grade of HCC is connected to the prognosis, and it is one of the independent predictive features for recurrence and long-term survival after hepatic resection [ 141 , 142 ]. However, it is challenging to define accurate preoperative grade using imaging modalities.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic evaluation and ablation treatments assessment in hepatocellular carcinoma

Granata

Grassi

Fusco³

et al. 2021

Infect Agents Cancer

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This article provides an overview of diagnostic evaluation and ablation treatment assessment in Hepatocellular Carcinoma (HCC). Only studies, in the English language from January 2010 to January 202, evaluating the diagnostic tools and assessment of ablative therapies in HCC patients were included. We found 173 clinical studies that satisfied the inclusion criteria.HCC may be noninvasively diagnosed by imaging findings. Multiphase contrast-enhanced imaging is necessary to assess HCC. Intravenous extracellular contrast agents are used for CT, while the agents used for MRI may be extracellular or hepatobiliary. Both gadoxetate disodium and gadobenate dimeglumine may be used in hepatobiliary phase imaging. For treatment-naive patients undergoing CT, unenhanced imaging is optional; however, it is required in the post treatment setting for CT and all MRI studies. Late arterial phase is strongly preferred over early arterial phase. The choice of modality (CT, US/CEUS or MRI) and MRI contrast agent (extracelllar or hepatobiliary) depends on patient, institutional, and regional factors. MRI allows to link morfological and functional data in the HCC evaluation. Also, Radiomics is an emerging field in the assessment of HCC patients.Postablation imaging is necessary to assess the treatment results, to monitor evolution of the ablated tissue over time, and to evaluate for complications. Post- thermal treatments, imaging should be performed at regularly scheduled intervals to assess treatment response and to evaluate for new lesions and potential complications.

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“…Hepatocellular carcinoma is unique, since a biopsy is not needed to make a diagnosis in most instances. But the disadvantage of this scenario is that we generally do not have access to information about the factors which strongly predict post‐transplant outcomes, including the grade of tumor, presence of vascular invasion, or degree of pathologic response 6,11,12 . Hence, it is crucial to determine which pre‐transplant factors can serve as surrogate markers of aggressive tumor biology.…”

Section: Discussionmentioning

confidence: 99%

“…including the grade of tumor, presence of vascular invasion, or degree of pathologic response. 6,11,12 Hence, it is crucial to determine which pre-transplant factors can serve as surrogate markers of aggressive tumor biology. Response to LRTs has been suggested to predict clinical outcomes, 13,14 We which likely limits the delivery of chemotherapeutic agents to the target.…”

Section: F I G U R Ementioning

confidence: 99%

Impact of Bridging Locoregional Therapies for Hepatocellular Carcinoma on Post‐transplant Clinical Outcome

Adeniji

Arjunan

Prabhakar

et al. 2020

Clinical Transplantation

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Long waiting times due to ongoing organ shortage have led to increased utilization of locoregional therapies (LRTs) to bridge patients with hepatocellular carcinoma (HCC) to liver transplantation (LT). We performed this study to evaluate the impact of LRTs on post-LT outcomes. We conducted a retrospective study of patients who were transplanted for HCC at Stanford University Hospital between 2008 and 2018 (n = 302). We found that receipt of ≥5 LRTs was an independent and significant predictor of poor overall 5-year survival (58.3% vs. 83.3%; HR 2.26, p = .03), poor recurrence-free 5-year survival (51.9% vs. 80.4%; HR 2.12, p = .03), and was associated with higher rates of recurrence (25.0% vs. 7.4%, p = .001). Moreover, recurrent HCC was more likely to be the cause of death (58.3% vs. 41.7%, p = .04) in patients who received ≥5 LRTs. Also, patients who required ≥5 LRTs showed an overall lower rate of radiological complete response (46.9% vs. 97.8%, p = .001) and were more likely to have more advanced pathological stage tumors in the explant (65.6% vs. 29.6%, p < .001). In conclusion, receipt of ≥5 bridging LRTs prior to LT is associated with worse post-transplant clinical outcomes.

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Factors Affecting Recurrence and Survival After Liver Transplantation for Hepatocellular Carcinoma

Cited by 10 publications

References 23 publications

Update on hepatocellular carcinoma: Pathologists’ review

Update on hepatocellular carcinoma: Pathologists’ review

Diagnostic evaluation and ablation treatments assessment in hepatocellular carcinoma

Impact of Bridging Locoregional Therapies for Hepatocellular Carcinoma on Post‐transplant Clinical Outcome

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