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Management of recurrent hepatocellular carcinoma in liver transplant recipients: a systematic review.

Abstract
Hepatocellular carcinoma is the most common form of liver cancer, representing 70% to 85% of primary hepatic malignancies in adults. Liver transplant is an optimal treatment for patients with hepatocellular carcinoma because it eliminates the malignancy as well as the often-underlying liver cirrhosis and restores normal liver function. Since the development of strict selection criteria in hepatocellular carcinoma patients undergoing liver transplant with the implementation of the Milan criteria, patient survival and recurrence rates after liver transplant have dramatically improved. However, several research groups are now seeking to expand this criteria to include more patients with larger tumors who may achieve similar postliver transplant survival rates as those patients meeting current eligibility requirements. Currently, in approximately 20% of patients, hepatocellular carcinoma recurrence is still the rate-limiting event that clearly affects patient survival. Given the limited number of grafts available for transplant, the poor prognosis of untreated hepatocellular carcinoma, and the recent notion of expanding selection criteria, strategies for reducing the rate of, monitoring and treating hepatocellular carcinoma recurrence, in both pretransplants and posttransplants, are explored in this review. We review the available literature to better understand current strategies available to optimize long-term clinical outcomes.
AuthorsJoshua Rubin, Noel Ayoub, Fady Kaldas, Sammy Saab
JournalExperimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation (Exp Clin Transplant) Vol. 10 Issue 6 Pg. 531-43 (Dec 2012) ISSN: 2146-8427 [Electronic] Turkey
PMID23216564 (Publication Type: Journal Article, Review, Systematic Review)
Topics
  • Adult
  • Carcinoma, Hepatocellular (prevention & control, therapy)
  • Humans
  • Liver Neoplasms (prevention & control, therapy)
  • Liver Transplantation
  • Neoplasm Recurrence, Local (prevention & control, therapy)

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