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. 2015 Oct 21;21(39):11185-98.
doi: 10.3748/wjg.v21.i39.11185.

Managements of recurrent hepatocellular carcinoma after liver transplantation: A systematic review

Nicola de'Angelis  1 , Filippo Landi  1 , Maria Clotilde Carra  1 , Daniel Azoulay  1
Affiliations

Managements of recurrent hepatocellular carcinoma after liver transplantation: A systematic review

Nicola de'Angelis et al. World J Gastroenterol. .

Abstract

Aim: To investigate the efficacy (survival) and safety of treatments for recurrent hepatocellular carcinoma (HCC) in liver transplantation (LT) patients.

Methods: Literature search was performed on available online databases without a time limit until January 2015. Clinical studies describing survival after HCC recurrence in LT patients were retrieved for a full-text evaluation. A total of 61 studies were selected: 13 case reports, 41 retrospective case series, and 7 retrospective comparative studies.

Results: Based on all included studies, the mean HCC recurrence rate was 16% of all LTs for HCC. A total of 1021 LT patients experienced HCC recurrence. The median time from LT to HCC recurrence was 13 mo (range 2-132 mo). The majority of patients (67%) presented with HCC extra-hepatic recurrences, involving lung, bone, adrenal gland, peritoneal lymph nodes, and rarely the brain. Overall survival after HCC recurrence was 12.97 mo. Surgical resection of localized HCC recurrence and Sorafenib for controlling systemic spread of HCC recurrence were associated with the higher survival rates (42 and 18 mo, respectively). However, Sorafenib, especially when combined with mTOR, was frequently associated with severe side effects that required dose reduction or discontinuation

Conclusion: Management of recurrent HCC in LT patients is challenging and associated with poor prognosis independently of the type of treatment.

Keywords: Liver transplantation; Recurrent hepatocellular carcinoma; Sorafenib; Surgical resection; Systematic review; Trans-arterial chemoembolization; Tumor recurrence.

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Figures

Figure 1
Figure 1
Flow chart of the electronic literature search strategy using MEDLINE, Scopus, EMBASE and other sources. Examples of PubMed Equations: recurrent hepatocellular carcinoma[Title/Abstract] OR recurrent hepatocellular carcinoma[MeSH Terms] OR hepatocellular carcinoma recurrence[Title/Abstract] AND liver transplantation[MeSH Terms] OR liver transplantation[Title/Abstract] OR liver transplant[Title/Abstract] OR liver transplant[MeSH Terms] AND treatment[Title/Abstract] OR therapy[Title/Abstract] OR management[Title/Abstract] OR recurrent hepatocellular carcinoma[Title/Abstract] OR recurrent hepatocellular carcinoma[MeSH Terms] OR hepatocellular carcinoma recurrence[Title/Abstract] AND liver transplantation[MeSH Terms] OR liver transplantation[Title/Abstract] OR liver transplant[Title/Abstract] OR liver transplant[MeSH Terms] AND sorafenib[Title/Abstract] OR sorafenib[MeSH Terms] OR Nexavar[Title/Abstract]) OR Nexavar[MeSH Terms]).
Figure 2
Figure 2
Increasing number of publication on the management of recurrent hepatocellular carcinoma in liver transplantation patients.
See this image and copyright information in PMC

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