Management of hepatocellular carcinoma recurrence after liver transplantation
Despite careful selection for liver transplantation (LT) of patients with hepatocellular carcinoma (HCC), HCC may still recur after LT and is frequently associated with dismal outcome. Tumor factors, including serum alpha-fetoprotein (AFP), the presence of microvascular invasion, tumor grade/differe...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-01-01
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| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268121003562 |
| _version_ | 1798014904090755072 |
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| author | Parul D. Agarwal Michael R. Lucey |
| author_facet | Parul D. Agarwal Michael R. Lucey |
| author_sort | Parul D. Agarwal |
| collection | DOAJ |
| description | Despite careful selection for liver transplantation (LT) of patients with hepatocellular carcinoma (HCC), HCC may still recur after LT and is frequently associated with dismal outcome. Tumor factors, including serum alpha-fetoprotein (AFP), the presence of microvascular invasion, tumor grade/differentiation, and largest tumor size are amongst the most important predictors of recurrence after transplantation. The nature of recurrence can be highly variable, but often presents with extra-hepatic involvement. As such, management of patients with HCC can be challenging, and consensus guidelines are lacking. Curative options, with surgery or ablation, which may be applicable in patients with isolated intra-or extrahepatic metastases, offer the best chance for improved long-term outcome in patients with HCC recurrence after transplantation. Most patients with recurrence have unresectable disease, and may benefit from palliative treatments, including intra-arterial therapies and/or systemic therapy. |
| first_indexed | 2024-04-11T15:24:47Z |
| format | Article |
| id | doaj.art-80754a21882b4051b873fe30f2295009 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-11T15:24:47Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-80754a21882b4051b873fe30f22950092022-12-22T04:16:16ZengElsevierAnnals of Hepatology1665-26812022-01-01271100654Management of hepatocellular carcinoma recurrence after liver transplantationParul D. Agarwal0Michael R. Lucey1Corresponding author.; Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Suite 4224, Madison, WI 53705, United StatesDivision of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Suite 4224, Madison, WI 53705, United StatesDespite careful selection for liver transplantation (LT) of patients with hepatocellular carcinoma (HCC), HCC may still recur after LT and is frequently associated with dismal outcome. Tumor factors, including serum alpha-fetoprotein (AFP), the presence of microvascular invasion, tumor grade/differentiation, and largest tumor size are amongst the most important predictors of recurrence after transplantation. The nature of recurrence can be highly variable, but often presents with extra-hepatic involvement. As such, management of patients with HCC can be challenging, and consensus guidelines are lacking. Curative options, with surgery or ablation, which may be applicable in patients with isolated intra-or extrahepatic metastases, offer the best chance for improved long-term outcome in patients with HCC recurrence after transplantation. Most patients with recurrence have unresectable disease, and may benefit from palliative treatments, including intra-arterial therapies and/or systemic therapy.http://www.sciencedirect.com/science/article/pii/S1665268121003562(In addition to title)Alpha fetoproteinAblationTrans-arterial chemoembolizationChemotherapy |
| spellingShingle | Parul D. Agarwal Michael R. Lucey Management of hepatocellular carcinoma recurrence after liver transplantation Annals of Hepatology (In addition to title) Alpha fetoprotein Ablation Trans-arterial chemoembolization Chemotherapy |
| title | Management of hepatocellular carcinoma recurrence after liver transplantation |
| title_full | Management of hepatocellular carcinoma recurrence after liver transplantation |
| title_fullStr | Management of hepatocellular carcinoma recurrence after liver transplantation |
| title_full_unstemmed | Management of hepatocellular carcinoma recurrence after liver transplantation |
| title_short | Management of hepatocellular carcinoma recurrence after liver transplantation |
| title_sort | management of hepatocellular carcinoma recurrence after liver transplantation |
| topic | (In addition to title) Alpha fetoprotein Ablation Trans-arterial chemoembolization Chemotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S1665268121003562 |
| work_keys_str_mv | AT paruldagarwal managementofhepatocellularcarcinomarecurrenceafterlivertransplantation AT michaelrlucey managementofhepatocellularcarcinomarecurrenceafterlivertransplantation |