scholarly journals Risk factors for poor survival after recurrence of hepatocellular carcinoma after liver transplantation

2021 ◽  
Vol 25 (1) ◽  
pp. S59-S59
Author(s):  
Jinsoo RHU ◽  
Jae-Won JOH ◽  
Gyu-Seong CHOI ◽  
Jong Man KIM
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Poor Survival

scholarly journals RISK FACTORS FOR POOR SURVIVAL AFTER RECURRENCE OF HEPATOCELLULAR CARCINOMA AFTER LIVER TRANSPLANTATION

2020 ◽  
Vol 104 (S3) ◽  
pp. S520-S520
Author(s):  
Jinsoo Rhu ◽  
Jae-Won Joh ◽  
Jong Man Kim ◽  
Gyu-Seong Choi ◽  
Min Jeong Kim
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Poor Survival

scholarly journals Cholangiocarcinoma: Has There been Any Progress?

2010 ◽  
Vol 24 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Judith Meza-Junco ◽  
Aldo J Montano-Loza ◽  
Mang Ma ◽  
Winnie Wong ◽  
Michael B Sawyer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Survival Rate ◽  
Surgical Resection ◽  
Survival Rates ◽  
Neoadjuvant Chemoradiation ◽  
Poor Survival ◽  
Single Centre ◽  
Micrometastatic Disease

Cholangiocarcinoma is the second most common primary hepatic tumour after hepatocellular carcinoma. Primary sclerosing cholangitis is one of the most commonly recognized risk factors for cholangiocarcinoma; however, approximately 90% of patients have no identifiable risk factors. Extrahepatic type is its most common presentation. Cholangiocarcinoma is considered to be a devastating disease, with a poor survival rate and few therapeutic options. Although surgical resection has been considered the best treatment option for localized cholangiocarcinoma, local recurrences of this cancer are very common, and imply persistent micrometastatic disease in lymph nodes or at surgical margins, even after extended surgical resection. Consequently, the five-year survival rate after attempted curative resection is only 20% to 40%. Early studies of liver transplantation for cholangiocarcinoma did not show a survival benefit and, currently, this tumour is considered to be an absolute contraindication for liver transplantation in most transplant centres worldwide. Recently, neoadjuvant chemoradiation in combination with liver transplantation for highly selected patients with cholangiocarcinoma has shown impressive results, with five-year survival rates at approximately 76% to 82% – similar to other standard indications for liver transplantation, such as hepatocellular carcinoma or hepatitis C-induced cirrhosis. However, this success of liver transplantation applies to only a subset of patients and most of the data originated from a single centre. Wider application of this strategy, especially for patients with potentially resectable disease, will require validation by other centres.

scholarly journals Risk factors for poor survival after recurrence of hepatocellular carcinoma after liver transplantation

2021 ◽  
Vol 101 (1) ◽  
pp. 28
Author(s):  
Minjeong Kim ◽  
Jinsoo Rhu ◽  
Gyu-Seong Choi ◽  
Jong Man Kim ◽  
Jae-Won Joh
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Poor Survival

Recurrent Hepatocellular Carcinoma After Liver Transplantation: Analysis of Risk Factors

2016 ◽  
Vol 48 (9) ◽  
pp. 2990-2993 ◽  
Author(s):  
E. Perea del Pozo ◽  
C. Bernal Bellido ◽  
M. Sendín Matín ◽  
C. Cepeda Franco ◽  
J.M. Álamo Martínez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Recurrent Hepatocellular Carcinoma

scholarly journals Risk factors for hepatocellular carcinoma recurrence after liver transplantation

2020 ◽  
Vol 2020 ◽  
Author(s):  
Pierluigi Toniutto ◽  
Ezio Fornasiere ◽  
Elisa Fumolo ◽  
Davide Bitetto
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Hepatocellular Carcinoma Recurrence

Homocysteine: A novel prognostic biomarker in liver transplantation for alpha-fetoprotein- negative hepatocellular carcinoma

2020 ◽  
Vol 29 (2) ◽  
pp. 197-206
Author(s):  
Modan Yang ◽  
Winyen Tan ◽  
Xinyu Yang ◽  
Jianyong Zhuo ◽  
Zuyuan Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Tumor Recurrence ◽  
Prognostic Biomarker ◽  
Milan Criteria ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Independent Risk Factors ◽  
Hcc Recurrence

BACKGROUND: Precise recipient selection optimizes the prognosis of liver transplantation (LT) for hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the most commonly used biomarker for diagnosis and prognosis of HCC in the clinical context. As a crucial molecule in methionine cycle, homocysteine (Hcy) level has been proved to be related to HCC progression and metastasis. OBJECTIVE: We aimed to explore the prognostic capacity of pre-transplant serum Hcy level in LT for HCC. METHODS: This study retrospectively enrolled 161 HCC patients who had underwent LT from donation after cardiac death (DCD) in the First Affiliated Hospital of Zhejiang University from 2015.01.01 to 2018.09.01. Pre-transplant serum Hcy level was incorporated into statistical analysis together with other clinical parameters and pathological features. RESULTS: From an overall perspective, significant difference was observed in Hcy level between recurrence (n= 61) and non-recurrence group (n= 100) though subsequent analysis showed unsatisfactory predicting performance. In the whole cohort, multivariate analysis showed that lnAFP (p= 0.010) and Milan criteria (MC, p< 0.001) were independent risk factors of HCC recurrence after LT. MA score based on MC and lnAFP performed well in predicting post-LT tumor recurrence with the AUROC at 0.836 (p< 0.001) and 3-year recurrence-free survival rate at 96.8% (p< 0.001) in the low risk group (n= 69). According to the clinical practice, serum concentration lower than 20 μg/L is considered as normal range of AFP. Elevated pre-transplant serum AFP (> 20 μg/L) predicts high HCC recurrence after LT. We further divided the 161 recipients into AFP- group (n= 77, AFP ⩽ 20 μg/L) and AFP+ group (n= 84, AFP > 20 μg/L). MA score was still well presented in the AFP+ group and the AUROC for tumor recurrence was 0.823 (p< 0.001), whereas the predicting accuracy was reduced in AFP- group (AUROC: 0.754, P< 0.001). After subsequent analysis, we found that elevated pre-transplant Hcy level (> 12.75 μmol/L) predicted increased tumor recurrence risk in AFP- group. The 3-year recurrence-free survival rates were 92.0% and 53.7% (p< 0.001) in low Hcy subgroup (n= 40) and high Hcy subgroup (n= 37) respectively. Multivariate analysis showed that Hcy (p= 0.040) and Milan criteria (p= 0.003) were independent risk factors for post-transplant tumor recurrence in AFP- group. Further combination of Hcy level and Milan criteria identified a subgroup of AFP- recipients with acceptable outcomes even though beyond Milan criteria (3-year recurrence-free survival rate: 77.7%, p< 0.001). CONCLUSION: As a classic predictor in HCC prognosis, AFP performed well in our study cohort when combined with Milan criteria. Homocysteine was an effective prognostic biomarker in LT for AFP- hepatocellular carcinoma. In recipients exceeding Milan criteria, acceptable post-transplant outcome could be seen in those with low Hcy and AFP level.

Chronic Hepatic Failure

2019 ◽  
Author(s):  
Derek J Erstad ◽  
Motaz Qadan
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Portal Hypertension ◽  
Hepatic Encephalopathy ◽  
Liver Failure ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
End Stage Liver Disease ◽  
End Stage

Continued hepatic injury by genetic or environmental factors results in a state of chronic inflammation, fibrosis, and progressive hepatocyte dysfunction that can progress to cirrhosis and end stage liver disease (ESLD). Cirrhosis is the eighth leading cause of mortality in the United States, while the burden of disease is even greater in regions with endemic viral hepatitis. Common risk factors include a history of hepatitis; alcohol or IV drug abuse; use of certain medications; and other risk factors associated with transmission of viral hepatitis, including tattoos, sexual promiscuity, and incarceration. Although many patients with cirrhosis are asymptomatic and remain undiagnosed, many will eventually develop secondary complications from chronic liver failure, which can be difficult to manage and are associated with significant morbidity, including: portal hypertension, variceal bleeding, coagulopathy, hepatic encephalopathy, and renal failure. In addition, hepatocellular carcinoma (HCC) is estimated to be 30 times more common among patients with cirrhosis, which can be an aggressive malignancy with 5-year overall survival of less than 15%. In this chapter, we provide a comprehensive overview of chronic liver failure, including the epidemiology of cirrhosis, pathophysiology of liver injury, and assessment and management of cirrhosis and associated downstream complications. Finally, we discuss the role of liver transplantation for both ESLD and HCC. This review contains 6 figures, 9 tables, and 53 references. Key Words: chronic liver failure, cirrhosis, coagulopathy, end stage liver disease, hepatic encephalopathy, hepatocellular carcinoma, hepatorenal syndrome, liver transplantation, portal hypertension, varices

Sign in / Sign up

Export Citation Format

Share Document