Liver transplantation in hepatocellular carcinoma

Wai, Chun-Tao; Lo, Shao-Jung; Lee, K.H; Tan, Cherie; Isacc, J; Prabhakaran, K.; Lim, Seng Gee; Tan, Kelvin Bryan

doi:10.1016/s0041-1345(00)01621-3

Cited by 6 publications

(2 citation statements)

References 12 publications

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“…After exclusion of duplicate publications, review articles, letters, case reports and studies reporting inappropriate outcome measures 67 relevant articles were identified for further full text review. Fifty‐four articles were subsequently excluded after full text review, due to a variety of reasons; studies with incidental tumours included, inappropriate outcome measures, simultaneous liver and kidney transplantation, inadequate sample size, follow‐up studies from the same register of recipients, inadequate or not recorded follow‐up, studies excluding patients with normal AFP levels and evidence of over‐fitting . This left 13 articles for inclusion in this review, involving 12 159 patients who underwent LT for HCC, of whom the majority were male (9603, 78.9%) with predominantly viral underlying aetiology …”

Section: Resultsmentioning

confidence: 99%

Systematic review: the prognostic role of alpha‐fetoprotein following liver transplantation for hepatocellular carcinoma

Hakeem

Young

Marangoni

et al. 2012

Aliment Pharmacol Ther

106

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Summary Background Liver transplantation (LT) offers a possible cure for carefully selected patients with hepatocellular carcinoma (HCC). Studies report that preoperative alpha‐fetoprotein (AFP) is a prognostic indicator that can predict survival and recurrence in these patients. Aim To undertake a systematic review of available literature on preoperative AFP as a predictor of survival and recurrence following LT for HCC. Methods A literature search was performed using Medline, Embase, Cochrane Library, CINAHL and Google scholar databases to identify studies reporting AFP as a prognostic marker in LT for HCC. Primary outcomes of interest were overall survival and recurrence. Secondary outcomes were correlation of pre‐LT AFP with vascular invasion and grade of tumour differentiation. Results A total of 13 studies met the inclusion criteria (12 159 patients). The majority were male (9603, 78.9%). All were observational studies and only one prospective. Methodological quality was rated as poor for all studies, with selection and observer bias apparent for most cohorts. Reported survival rates and recurrence rates varied widely between the studies although overall demonstrated better outcomes for those with lower (<1000 ng/mL) pre‐LT AFP levels. Similarly, rates of vascular invasion and poor tumour differentiation were higher in those with high pre‐LT AFP levels. Conclusions A quantity of AFP >1000 ng/mL is associated with poorer outcomes from liver transplantation for hepatocellular carcinoma. The quality of studies was generally poor and precluded valid statistical meta‐analysis. There is a need to improve the performance and reporting of primary prognostic studies to facilitate high quality systematic review and meta‐analysis.

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Section: Resultsmentioning

confidence: 99%

Systematic review: the prognostic role of alpha‐fetoprotein following liver transplantation for hepatocellular carcinoma

Hakeem

Young

Marangoni

et al. 2012

Aliment Pharmacol Ther

106

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“…Many transplant centers in Asia accept patients with extended criteria. Even in centers that have adopted the Milan or UCSF criteria [43,[92][93][94], patients with extended criteria are considered on a case-by-case basis, taking into account the presence of risk factors for recurrence individually and the wishes of the patient and his/her family, especially when they strongly request LDLT. The centers surveyed have evaluated their outcomes according to the Milan criteria.…”

Section: Overview Of Experience With Liver Transplantationmentioning

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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