Research Article
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Hepatocellular Cancer and Liver Transplantation; Is There Any Novelty in Prognostic Factors For Survival and Recurrence?

Year 2024, Volume: 15 Issue: 1, 24 - 30, 31.01.2024
https://doi.org/10.31067/acusaglik.1340768

Abstract

Background/Purpose: Hepatocellular cancer constitutes 75-85% of liver cancers, and its treatment requires a multidisciplinary approach. Milan criteria are golden standart candidate selection criteria that ensure excellent posttransplant survival and follow up with low recurrence rate. However, other classifications include histopathological features or biological behaviors may vary survival and recurrence. We examined the parameters that may have prognostic value in out study.
Methods: 217 patients for recurrence, 226 patients for overall survival, 48 patients for disease free survival, whose explant pathology is hepatocellular carcinoma and data information can be obtained were evaluated. Recurrence and overall survival and disease free survival were statistically analyzed in terms of age, gender, living and cadaveric transplanted patient groups, blood group, BMİ, MELD and Child scores, milan criteria and pathological parameters. All survival rates were evaluated in terms of recurrent organ location, number of organ recurrence, and survival rates.
Results: There were less recurrence rates in patients, with 0 blood group, inside milan, with less total and maximum tumor diameter. It was also observed that the maximum tumor size affected the overall survival multivariately It was observed that survival was worse in early recurrence and recurrence in the first 24 months.
Conclusion: İt is observed that being inside the milan and tumor diameter affect the recurrence and survival, surgery to be performed in localized recurrences and additional systemic treatment will affect survival positively.

References

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  • 2. Sapisochin G, Bruix J. Liver transplantation for hepatocellular carcinoma: outcomes and novel surgical approaches. Nat Rev Gastroenterol Hepatol. 2017 Apr;14(4):203-217.
  • 3. Xiao Xu, Di Lu, Qi Ling, et al. Liver transplantation for hepatocellular carcinoma beyond the Milan criteria. Gut. 2016 Jun;65(6):1035-41.
  • 4. Hai-Ming Zhang, Yue-Xian Shi, Li-Ying Sun, et al. Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis. Chin Med J (Engl), July 2019, (13): 1599-1609.
  • 5. Zhu B, Wang J, Li H, et al. Living or deceased organ donors in liver transplantation for hepatocellular carcinoma: a systematic review and meta-analysis. HPB (Oxford). 2019 Feb;21(2):133-147.
  • 6. Citores MJ, Lucena JL, De La Fuente S, et al. Serum biomarkers and risk of hepatocellular carcinoma recurrence after liver transplantation. World J Hepatol. 2019 Jan 27;11(1):50-64.
  • 7. Vatche G Agopian, Michael Harlander-Locke, Ali Zarrinpar, et al. A novel prognostic nomogram accurately predicts hepatocellular carcinoma recurrence after liver transplantation: analysis of 865 consecutive liver transplant recipients. J Am Coll Surg. 2015 Apr;220(4):416-27.
  • 8. John P Duffy, Andrew Vardanian, Elizabeth Benjamin, et al. Liver Transplantation Criteria for Hepatocellular Carcinoma Should Be Expanded: A 22-year Experience With 467 Patients at UCLA. Ann Surg. 2007 Sep;246(3):502-9; discussion 509-11.
  • 9. Samir Zeair, Justyna Rajchert, Robert Stasiuk, et al. Recurrence of Hepatocellular Carcinoma After Liver Transplantation: A Single-Center Experience. Ann Transplant . 2019 Aug 23;24:499-505.
  • 10. L Xiao, Z-R Fu, G-S Ding, et al. Liver transplantation for hepatitis B virus-related hepatocellular carcinoma: one center's experience in China. Transplant Proc . 2009 Jun;41(5):1717-21.
  • 11. Karim J Halazun, Marc Najjar, Rita M Abdelmessih, et al. Recurrence After Liver Transplantation for Hepatocellular Carcinoma: A New MORAL to the Story. Ann Surg . 2017 Mar;265(3):557-564.
  • 12. Jian Dong, Ying Zhu, Feng Ma, et al. Conditional disease-free survival after liver transplantation for hepatocellular carcinoma A two-center experience. Medicine (Baltimore). 2016 Aug; 95(31): e4383.
  • 13. A Daoud, L Teeter, R M Ghobrial, et al. Transplantation for Hepatocellular Carcinoma: Is There a Tumor Size Limit? Transplant Proc. 2018 Dec;50(10):3577-3581.
  • 14. Christin Bürger, Miriam Maschmeier, Anna Hüsing-Kabar, et al. Achieving Complete Remission of Hepatocellular Carcinoma: A Significant Predictor for Recurrence-Free Survival after Liver Transplantation. Can J Gastroenterol Hepatol. 2019; 2019: 5796074.
  • 15. Jiliang Feng, Ruidong Zhu, Dezhao Feng, et al. Prediction of Early Recurrence of Solitary Hepatocellular Carcinoma after Orthotopic Liver Transplantation. Scientific Reports volume 9, Article number: 15855 (2019).
  • 16. Sasan Roayaie 1 , Jason S Frischer, Sukru H Emre, et al. Long-Term Results With Multimodal Adjuvant Therapy and Liver Transplantation for the Treatment of Hepatocellular Carcinomas Larger Than 5 Centimeters. Ann Surg. 2002 Apr; 235(4): 533-539.
  • 17. Theodore H Welling, Kevin Eddinger, Kristen Carrier, et al. Multicenter Study of Staging and Therapeutic Predictors of Hepatocellular Carcinoma Recurrence Following Transplantation. Liver Transpl. 2018; 24: 1233-1242.
  • 18. François Durand, Jacques Belghiti. Liver Transplantation for Hepatocellular Carcinoma: Should We Push the Limits? . Liver Transpl. 2003 Jul;9(7):697-9.
  • 19. Pawlik TM, Delman KA, Vauthey JN, et al. Tumor size predicts vascular invasion and histologic grade: Implications for selection of surgical treatment for hepatocellular carcinoma. Liver Transpl 2005; 11: 1086-1092.
  • 20. Zhang H, Yuan SX, Dai SY, et al. Tumor size does not independently affect long-term survival after curative resection of solitary hepatocellular carcinoma without macroscopic vascular invasion. World J Surg 2014; 38: 947-957.
  • 21. Kevin Ka-Wan Chu, Kelly Hiu-Ching Wong, Kenneth Siu-Ho Chok. Expanding Indications for Liver Transplant: Tumor and Patient Factors. Gut Liver . 2020 Feb 28.
  • 22. Friedrich Foerster, Maria Hoppe-Lotichius, Johanna Vollmar, et al. Long-term observation of hepatocellular carcinoma recurrence after liver transplantation at a European transplantation centre. United European Gastroenterol J. 2019 Jul; 7(6): 838–849.
  • 23. A Kornberg, B Küpper, A Tannapfel, et al. Long-term survival after recurrent hepatocellular carcinoma in liver transplant patients: clinical patterns and outcome variables. Eur J Surg Oncol. 2010 Mar; 36(3):275-80.
  • 24. Adam S Bodzin, Keri E Lunsford, Daniela Markovic, et al. Predicting Mortality in Patients Developing Recurrent Hepatocellular Carcinoma After Liver Transplantation: Impact of Treatment Modality and Recurrence Characteristics. Ann Surg. 2017 Jul;266(1):118-125.
  • 25. FY Yao, L Ferrell, N M Bass, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology. 2001 Jun;33(6):1394-403.
  • 26. Jun Zhao, J Mao, W Li. Association of Tumor Grade With Long-Term Survival in Patients With Hepatocellular Carcinoma After Liver Transplantation. Transplant Proc . 2019 Apr;51(3):813-819.
  • 27. Georgios C Sotiropoulos, E P Molmenti, C Lösch, S Beckebaum, et al. Meta-analysis of tumor recurrence after liver transplantation for hepatocellular carcinoma based on 1,198 cases. Eur. J. Med. Res. 12, 527-534 (2007). 28. William C. Palmer, David Lee, Justin Burns, et al. Liver Transplantation for Hepatocellular Carcinoma: Impact of Wait Time at a Single Center. Annals of Hepatology. Vol. 16. Issue 3. pages 402-411.
  • 29. Claudio Zavaglia, Luciano De Carlis, Alberto Battista Alberti, et al. Predictors of Long-Term Survival After Liver Transplantation for Hepatocellular Carcinoma. Am J Gastroenterol. 2005 Dec;100(12):2708-16.
  • 30. Patrick P McHugh, Jeffrey Gilbert, Santiago Vera, et al. Alpha-fetoprotein and tumour size are associated with microvascular invasion in explanted livers of patients undergoing transplantation with hepatocellular carcinoma. HPB (Oxford) . 2010 Feb;12(1):56-61.
Year 2024, Volume: 15 Issue: 1, 24 - 30, 31.01.2024
https://doi.org/10.31067/acusaglik.1340768

Abstract

References

  • 1. Zhang, K. Survival outcomes of liver transplantation versus liver resection among patients with hepatocellular carcinoma: A SEER-based longitudinal study. 118, 2019, J Formos Med Assoc., p. 790-796.
  • 2. Sapisochin G, Bruix J. Liver transplantation for hepatocellular carcinoma: outcomes and novel surgical approaches. Nat Rev Gastroenterol Hepatol. 2017 Apr;14(4):203-217.
  • 3. Xiao Xu, Di Lu, Qi Ling, et al. Liver transplantation for hepatocellular carcinoma beyond the Milan criteria. Gut. 2016 Jun;65(6):1035-41.
  • 4. Hai-Ming Zhang, Yue-Xian Shi, Li-Ying Sun, et al. Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis. Chin Med J (Engl), July 2019, (13): 1599-1609.
  • 5. Zhu B, Wang J, Li H, et al. Living or deceased organ donors in liver transplantation for hepatocellular carcinoma: a systematic review and meta-analysis. HPB (Oxford). 2019 Feb;21(2):133-147.
  • 6. Citores MJ, Lucena JL, De La Fuente S, et al. Serum biomarkers and risk of hepatocellular carcinoma recurrence after liver transplantation. World J Hepatol. 2019 Jan 27;11(1):50-64.
  • 7. Vatche G Agopian, Michael Harlander-Locke, Ali Zarrinpar, et al. A novel prognostic nomogram accurately predicts hepatocellular carcinoma recurrence after liver transplantation: analysis of 865 consecutive liver transplant recipients. J Am Coll Surg. 2015 Apr;220(4):416-27.
  • 8. John P Duffy, Andrew Vardanian, Elizabeth Benjamin, et al. Liver Transplantation Criteria for Hepatocellular Carcinoma Should Be Expanded: A 22-year Experience With 467 Patients at UCLA. Ann Surg. 2007 Sep;246(3):502-9; discussion 509-11.
  • 9. Samir Zeair, Justyna Rajchert, Robert Stasiuk, et al. Recurrence of Hepatocellular Carcinoma After Liver Transplantation: A Single-Center Experience. Ann Transplant . 2019 Aug 23;24:499-505.
  • 10. L Xiao, Z-R Fu, G-S Ding, et al. Liver transplantation for hepatitis B virus-related hepatocellular carcinoma: one center's experience in China. Transplant Proc . 2009 Jun;41(5):1717-21.
  • 11. Karim J Halazun, Marc Najjar, Rita M Abdelmessih, et al. Recurrence After Liver Transplantation for Hepatocellular Carcinoma: A New MORAL to the Story. Ann Surg . 2017 Mar;265(3):557-564.
  • 12. Jian Dong, Ying Zhu, Feng Ma, et al. Conditional disease-free survival after liver transplantation for hepatocellular carcinoma A two-center experience. Medicine (Baltimore). 2016 Aug; 95(31): e4383.
  • 13. A Daoud, L Teeter, R M Ghobrial, et al. Transplantation for Hepatocellular Carcinoma: Is There a Tumor Size Limit? Transplant Proc. 2018 Dec;50(10):3577-3581.
  • 14. Christin Bürger, Miriam Maschmeier, Anna Hüsing-Kabar, et al. Achieving Complete Remission of Hepatocellular Carcinoma: A Significant Predictor for Recurrence-Free Survival after Liver Transplantation. Can J Gastroenterol Hepatol. 2019; 2019: 5796074.
  • 15. Jiliang Feng, Ruidong Zhu, Dezhao Feng, et al. Prediction of Early Recurrence of Solitary Hepatocellular Carcinoma after Orthotopic Liver Transplantation. Scientific Reports volume 9, Article number: 15855 (2019).
  • 16. Sasan Roayaie 1 , Jason S Frischer, Sukru H Emre, et al. Long-Term Results With Multimodal Adjuvant Therapy and Liver Transplantation for the Treatment of Hepatocellular Carcinomas Larger Than 5 Centimeters. Ann Surg. 2002 Apr; 235(4): 533-539.
  • 17. Theodore H Welling, Kevin Eddinger, Kristen Carrier, et al. Multicenter Study of Staging and Therapeutic Predictors of Hepatocellular Carcinoma Recurrence Following Transplantation. Liver Transpl. 2018; 24: 1233-1242.
  • 18. François Durand, Jacques Belghiti. Liver Transplantation for Hepatocellular Carcinoma: Should We Push the Limits? . Liver Transpl. 2003 Jul;9(7):697-9.
  • 19. Pawlik TM, Delman KA, Vauthey JN, et al. Tumor size predicts vascular invasion and histologic grade: Implications for selection of surgical treatment for hepatocellular carcinoma. Liver Transpl 2005; 11: 1086-1092.
  • 20. Zhang H, Yuan SX, Dai SY, et al. Tumor size does not independently affect long-term survival after curative resection of solitary hepatocellular carcinoma without macroscopic vascular invasion. World J Surg 2014; 38: 947-957.
  • 21. Kevin Ka-Wan Chu, Kelly Hiu-Ching Wong, Kenneth Siu-Ho Chok. Expanding Indications for Liver Transplant: Tumor and Patient Factors. Gut Liver . 2020 Feb 28.
  • 22. Friedrich Foerster, Maria Hoppe-Lotichius, Johanna Vollmar, et al. Long-term observation of hepatocellular carcinoma recurrence after liver transplantation at a European transplantation centre. United European Gastroenterol J. 2019 Jul; 7(6): 838–849.
  • 23. A Kornberg, B Küpper, A Tannapfel, et al. Long-term survival after recurrent hepatocellular carcinoma in liver transplant patients: clinical patterns and outcome variables. Eur J Surg Oncol. 2010 Mar; 36(3):275-80.
  • 24. Adam S Bodzin, Keri E Lunsford, Daniela Markovic, et al. Predicting Mortality in Patients Developing Recurrent Hepatocellular Carcinoma After Liver Transplantation: Impact of Treatment Modality and Recurrence Characteristics. Ann Surg. 2017 Jul;266(1):118-125.
  • 25. FY Yao, L Ferrell, N M Bass, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology. 2001 Jun;33(6):1394-403.
  • 26. Jun Zhao, J Mao, W Li. Association of Tumor Grade With Long-Term Survival in Patients With Hepatocellular Carcinoma After Liver Transplantation. Transplant Proc . 2019 Apr;51(3):813-819.
  • 27. Georgios C Sotiropoulos, E P Molmenti, C Lösch, S Beckebaum, et al. Meta-analysis of tumor recurrence after liver transplantation for hepatocellular carcinoma based on 1,198 cases. Eur. J. Med. Res. 12, 527-534 (2007). 28. William C. Palmer, David Lee, Justin Burns, et al. Liver Transplantation for Hepatocellular Carcinoma: Impact of Wait Time at a Single Center. Annals of Hepatology. Vol. 16. Issue 3. pages 402-411.
  • 29. Claudio Zavaglia, Luciano De Carlis, Alberto Battista Alberti, et al. Predictors of Long-Term Survival After Liver Transplantation for Hepatocellular Carcinoma. Am J Gastroenterol. 2005 Dec;100(12):2708-16.
  • 30. Patrick P McHugh, Jeffrey Gilbert, Santiago Vera, et al. Alpha-fetoprotein and tumour size are associated with microvascular invasion in explanted livers of patients undergoing transplantation with hepatocellular carcinoma. HPB (Oxford) . 2010 Feb;12(1):56-61.

Details

Primary Language English
Subjects Transplantation, Gastroenterology and Hepatology
Journal Section Research Articles
Authors

Ender ANILIR 0000-0002-0024-1790

Alihan ORAL 0000-0003-1160-9340

Fatih TÜRKER 0000-0002-8281-0319

Tolga ŞAHİN 0000-0003-1569-4941

Yıldıray YÜZER 0000-0002-2952-4786

Yaman TOKAT 0000-0002-9899-1521

Publication Date January 31, 2024
Submission Date August 11, 2023
Published in Issue Year 2024Volume: 15 Issue: 1

Cite

EndNote ANILIR E, ORAL A, TÜRKER F, ŞAHİN T, YÜZER Y, TOKAT Y (January 1, 2024) Hepatocellular Cancer and Liver Transplantation; Is There Any Novelty in Prognostic Factors For Survival and Recurrence?. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 15 1 24–30.