Long-term Survival After Liver Transplant for Recurrent Hepatocellular Carcinoma With Bile Duct Tumor Thrombus: Case Report

Liu, Chao; Wang, Jie

doi:10.6002/ect.2012.0022

Cited by 2 publications

(1 citation statement)

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“…Of these 10 studies, an additional three were ultimately excluded. The excluded papers included a 20-patient review of pathological characteristics of HCC with BDTT, in which two patients underwent transplantation; one patient was lost to follow-up and the second was the subject of a more recent case report by the same authors which was already included as an independent paper in this study ( 9 , 10 ). Two papers by Peng et al provided a review of the same patient, and so the case report with more recent follow-up was included ( 11 , 12 ).…”

Section: Resultsmentioning

confidence: 99%

Liver Transplantation for Hepatocellular Carcinoma With Bile Duct Tumor-Associated Thrombi: A Systematic Review and Pooled Analysis

et al. 2022

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IntroductionThe significance of bile duct tumor-associated thrombi in patients undergoing transplantation for hepatocellular carcinoma (HCC) is controversial. Therefore, we performed a systematic review of the literature with pooled analysis to investigate the impact of biliary invasion on HCC recurrence and patient survival.MethodsOf 1,584 references screened, eight were included for analysis. Demographics, patient and tumor factors, recurrence, and survival data were analyzed. Time to recurrence and death were extracted from each paper by cross-referencing survival curves.ResultsA total of 35 patients across eight studies were pooled for analysis when follow-up data were available. At 1 year, 92.9% of patients undergoing transplantation for HCC with bile duct thrombi were alive. Overall survival at 3 and 5 years was 65.5 and 49.6%, respectively. At 1 year, 21.6% of patients had recurrence of their disease, while at 3 years, 50.4% of patients had recurrence. Of those patients with recurrence in the first year, 71.4% recurred within the first 3 months after transplantation.ConclusionOverall patient survival decreased within the first 5 years, but then stabilized. The 5-year survival rate of 49.6% in this pooled analysis is lower than that reported for patients undergoing transplantation for HCC within the Milan criteria (50–78%) or recent reports in patients with portal vein involvement (63.6%), though data is limited by a lack of long-term follow-up in this understudied population. Transplantation for patients with HCC with bile duct involvement may be a viable treatment option, warranting further investigation.

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