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hepatocellular carcinoma and liver transplantation

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https://www.readbyqxmd.com/read/28340509/liver-transplant-lt-recipients-with-nonalcoholic-steatohepatitis-nash-have-lower-risk-hepatocellular-carcinoma-hcc
#1
Sara M Lewin, Neil Mehta, R Kate Kelley, John P Roberts, Francis Y Yao, Danielle Brandman
BACKGROUND: Liver transplantation is a well-established treatment for HCC in carefully selected patients. Risk factors for tumors with poor prognostic features on explant have not been well described in a national cohort. METHODS: We performed a retrospective cohort study of adult LT recipients with HCC transplanted from 4/8/12 (when explant pathology in UNOS became available) until 9/30/2014. We evaluated the association between listing diagnosis and other demographic factors with tumor features on explant using logistic regression...
March 24, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28333015/role-of-stereotactic-body-radiation-therapy-before-orthotopic-liver-transplantation-retrospective-evaluation-of-pathologic-response-and-outcomes
#2
Edward Michael Mannina, Higinia Rosa Cardenes, Foster D Lasley, Benjamin Goodman, Jennifer Zook, Sandra Althouse, John Alvin Cox, Romil Saxena, Joseph Tector, Mary Maluccio
PURPOSE: To analyze the results of stereotactic body radiation therapy (SBRT) in patients with early-stage, localized hepatocellular carcinoma who underwent definitive orthotopic liver transplantation (OLT). METHODS AND MATERIALS: The subjects of this retrospective report are 38 patients diagnosed with hepatocellular carcinoma who underwent SBRT per institutional phase 1 to 2 eligibility criteria, before definitive OLT. Pre-OLT radiographs were compared with pathologic gold standard...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28323121/the-treatment-of-intermediate-stage-tumour-beyond-tace-from-surgery-to-systemic-therapy
#3
REVIEW
Peter R Galle, Francesco Tovoli, Friedrich Foerster, Marcus A Wörns, Alessandro Cucchetti, Luigi Bolondi
Intermediate stage hepatocellular carcinoma (HCC) comprises the largest subgroup of patients with this disease and is characterized by substantial heterogeneity. Functional liver impairment, total tumour burden and other prognostic factors such as high alpha-fetoprotein serum level, presence of micro-vascular invasion, and poorly differentiated tumours relevantly contribute to outcome. The usage of the standard therapeutic approach, transarterial chemoembolization - TACE, for all intermediate stage HCC patients is probably an over-simplification and may therefore not be appropriate for all patients...
March 17, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28321877/pharmacological-interventions-for-acute-hepatitis-b-infection-an-attempted-network-meta-analysis
#4
REVIEW
Konstantinos Mantzoukis, Manuel Rodríguez-Perálvarez, Elena Buzzetti, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Infection with hepatitis B virus (HBV) can be symptomatic or asymptomatic. Apart from chronic HBV infection, the complications related to acute HBV infection are severe acute viral hepatitis and fulminant hepatitis characterised by liver failure. The optimal pharmacological treatment of acute HBV infection remains controversial. OBJECTIVES: To assess the benefits and harms of pharmacological interventions in the treatment of acute HBV infection through a network meta-analysis and to generate rankings of the available treatments according to their safety and efficacy...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28321274/risk-factors-for-hepatocellular-carcinoma-in-cirrhosis-due-to-nonalcoholic-fatty-liver-disease-a-multicenter-case-control-study
#5
Kathleen E Corey, Samer Gawrieh, Andrew S deLemos, Hui Zheng, Andrew E Scanga, Jennifer W Haglund, Jorge Sanchez, Christopher J Danford, Megan Comerford, Krista Bossi, Samina Munir, Naga Chalasani, Julia Wattacheril
AIM: To identify risk factors associated with hepatocellular carcinoma (HCC), describe tumor characteristics and treatments pursed for a cohort of individuals with nonalcoholic steatohepatitis (NASH) cirrhosis. METHODS: We conducted a retrospective case-control study of a well-characterized cohort of patients among five liver transplant centers with NASH cirrhosis with (cases) and without HCC (controls). RESULTS: Ninety-four cases and 150 controls were included...
March 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28321272/future-of-liver-disease-in-the-era-of-direct-acting-antivirals-for-the-treatment-of-hepatitis-c
#6
REVIEW
Francesca Romana Ponziani, Francesca Mangiola, Cecilia Binda, Maria Assunta Zocco, Massimo Siciliano, Antonio Grieco, Gian Lodovico Rapaccini, Maurizio Pompili, Antonio Gasbarrini
Hepatitis C virus (HCV) infection has been a global health problem for decades, due to the high number of infected people and to the lack of effective and well-tolerated therapies. In the last 3 years, the approval of new direct acting antivirals characterized by high rates of virological clearance and excellent tolerability has dramatically improved HCV infection curability, especially for patients with advanced liver disease and for liver transplant recipients. Long-term data about the impact of the new direct acting antivirals on liver fibrosis and liver disease-related outcomes are not yet available, due to their recent introduction...
March 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28318501/sorafenib-use-for-recurrent-hepatocellular-cancer-after-resection-or-transplantation-observations-from-a-us-regional-analysis-of-the-gideon-registry
#7
Robert C G Martin, Elizabeth Bruenderman, Allen Cohn, Bilal Piperdi, Rebecca Miksad, Jean-Francois Geschwind, Alec Goldenberg, Arun Sanyal, Ellen Zigmont, Svetlana Babajanyan, Pamela Foreman, Parvez Mantry, Brendan McGuire, Pierre Gholam
Treatment of unresectable recurrent hepatocellular carcinoma (HCC) in patients who recur after resection or orthotopic liver transplantation (OLT) remains a clinical challenge. One option is sorafenib, although little is known about its safety and tolerance in this unique patient population; therefore, we analyzed patients who underwent prior surgical resection and/or OLT and were treated with sorafenib in US cohort of GIDEON registry. In US, 645 patients were enrolled; 553 for intent to treat and 563 for safety...
November 18, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28315062/expansion-of-criteria-for-liver-transplantation-in-hepatocellular-carcinoma-better-patient-selection-or-a-slippery-slope
#8
EDITORIAL
Adam C Yopp, Jorge A Marrero, Amit G Singal
No abstract text is available yet for this article.
March 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28314323/bevacizumab-combined-with-chemotherapy-in-children-affected-by-hepatocellular-carcinoma-a-single-center-experience
#9
Maria Debora DE Pasquale, Jean de Ville de Goyet, Lidia Monti, Chiara Grimaldi, Alessandro Crocoli, Aurora Castellano
BACKGROUND: Hepatocellular carcinoma (HCC) is very rare in children and is traditionally associated with a poor prognosis because many patients are not amenable to conventional resection, even in the absence of metastatic disease. For patients with locally advanced or metastatic tumors, conventional chemotherapy appears to offer limited survival benefits. PATIENTS AND METHODS: We report a case series of five consecutive pediatric patients with HCC who were treated with bevacizumab along with conventional platinum-based chemotherapy...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28302995/conversion-from-calcineurin-inhibitor-based-immunosuppression-to-mycophenolate-mofetil-in-monotherapy-reduces-risk-of-de-novo-malignancies-after-liver-transplantation
#10
Diego Aguiar, Diego Martínez-Urbistondo, Delia D'Avola, Mercedes Iñarrairaegui, Fernando Pardo, Fernando Rotellar, Bruno Sangro, Jorge Quiroga, Jose Ignacio Herrero
BACKGROUND Immunosuppression increases the risk of malignancy in liver transplant recipients. The potential impact of mycophenolate mofetil monotherapy on this risk has not been studied. MATERIAL AND METHODS The incidence and risk factors for de novo malignancies of 392 liver transplant recipients with a survival higher than 3 months and a mean follow-up of 8.5 years were studied. RESULTS De novo malignancies were diagnosed in 126 patients (32.1%) (64 non-melanoma skin cancer and 81 other malignancies). Sixty-nine patients (18...
March 17, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28302002/preoperative-cardiac-risk-assessment-in-patients-undergoing-liver-transplant-due-to-hepatocellular-carcinoma-should-it-be-different
#11
Haldun Muderrisoglu, Kerem Can Yilmaz, Emir Karacaglar, Ugur Bal, Alp Aydinalp, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Liver transplant is a high-risk surgery for cardiac events. The risk of 30-day major cardiac adverse events is estimated at more than 5%. In this retrospective study, we evaluated our preoperative cardiac risk assessment approach. MATERIALS AND METHODS: We evaluated 58 adult patients who underwent liver transplant between May 2011 and May 2015. Preoperative cardiac risk factors and results of diagnostic tests were noted. Patients were divided into 2 groups: patients with or without hepatocellular carcinoma...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28302001/liver-transplantation-for-hepatocellular-carcinoma-beyond-the-milan-criteria
#12
Fulya Gunsar
Hepatocellular carcinoma is the most common primary liver malignancy. Liver transplantation has been a successful therapy for selected patients with hepatocellular carcinoma. Since 1996, Milan criteria have been universally recognized as the guidelines for selecting patients with hepatocellular carcinoma for orthotopic liver transplantation. However, the simple use of tumor size and number has been insufficient to indicate the biologic features of hepatocellular carcinoma and to predict the risk of tumor recurrence...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28302000/expanded-criteria-for-hepatocellular-carcinoma-in-liver-transplant
#13
Mehmet Haberal, Aydıncan Akdur, Gökhan Moray, Gülnaz Arslan, Figen Özçay, Haldun Selçuk, Handan Özdemir
OBJECTIVES: Hepatocellular carcinoma is the sixth most common cancer worldwide and is the third highest cause of malignancy-related death. Because of its typically late diagnosis, median survival is approximately 6 to 20 months, with 5-year survival of < 12%. Hepatocellular carcinoma typically arises in the background of cirrhosis, with liver transplant regarded as the optimal therapy for selected patients. Initially, orthotopic liver transplant was limited to patients with extensive unresectable tumors, resulting in uniformly dismal outcomes due to high tumor recurrence rates...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301999/liver-transplant-for-hepatocellular-carcinoma-pathologic-point-of-view
#14
Gonca Özgün, Nihan Haberal Reyhan, Binnaz Handan Özdemir, Mehmet Haberal
Primary liver cancer is the fifth most common cancer overall and the second most common cause of cancer mortality worldwide. Hepatocellular carcinoma accounts for up to 90% of all primary hepatic malignancies and represents a major international health problem. It is a complex and heterogeneous malignancy, frequently occurs in the setting of a chronically diseased organ, and has multiple confounding factors. Liver transplant for hepatocellular carcinoma has been established as a standard treatment in selected patients...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301997/hepatocellular-carcinoma-in-the-cirrhotic-liver-evaluation-using-computed-tomography-and-magnetic-resonance-imaging
#15
Mehmet Coskun
Hepatocellular carcinoma is the fifth most common tumor in patients worldwide and the third most common cause of cancer-related death, after lung and stomach cancer. Cirrhosis of the liver is the strongest predisposing factor for hepatocellular carcinoma, with approximately 80% of cases of hepatocellular carcinoma developing in a cirrhotic liver. The annual incidence of hepatocellular carcinoma is 2.0% to 6.6% in patients with cirrhosis compared with 0.4% in patients without cirrhosis. The 5-year survival rates of patients undergoing curative therapies for hepatocellular carcinoma, including liver transplant, hepatic resection, and percutaneous ablative techniques, range between 40% and 75%...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301996/management-of-hepatocellular-carcinoma-prevention-surveillance-diagnosis-and-staging
#16
Digdem Ozer Etik, Nurettin Suna, Ahmet Sedat Boyacioglu
More than 600 000 people die from hepatocellular carcinoma each year. Worldwide, research on the disease needs to be intensified in both the medical and pharmaceutical fields, with a focus on providing help to geographic areas where resources are limited. Treatment approaches depend on the stage of the disease at diagnosis and on access to complex treatment regimens. However, advanced disease is not curable, and treating these patients is expensive and only marginally effective for increasing quality-adjusted life-years...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301994/does-preoperative-transarterial-chemoembolization-for-hepatocellular-carcinoma-increase-the-incidence-of-hepatic-artery-thrombosis-after-living-donor-liver-transplant
#17
Volkan Ince, Veysel Ersan, Serdar Karakas, Koray Kutluturk, Nese Karadag, Ramazan Kutlu, Sezai Yilmaz
OBJECTIVES: Transarterial chemoembolization is a potential risk factor for hepatic artery damage, which may lead to severe consequences. We aimed to investigate this controversial issue in our population of liver transplant patients with hepatocellular carcinoma. MATERIALS AND METHODS: Between March 2006 and December 2016, a total of 262 patients with hepatocellular carcinoma underwent liver transplant at our institution. Of these, 22 (8.4%) had preoperative transarterial chemoembolization...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301993/outcome-of-living-donor-liver-transplant-for-hepatocellular-carcinoma-15-year-single-center-experience-in-egypt
#18
Refaat Kamel, Yaser Hatata, Karim Hosny, Ahmed Nabil, Alaa El-Deen Abd-Allah, Aaser Mostafa, Amr Abdel-Aal, Mahmoud Z Elganzoury, Osama Elmalt, Ibrahim Marwan, Adel Hosny
OBJECTIVES: Liver transplant performed for hepatocellular carcinoma must adhere to criteria for the size and number of focal hepatic lesions to lower the incidence of recurrence and achieve survival rates comparable to patients transplanted for other indications. Since the Milan criteria were established in 1996, there have been many less restrictive criteria yielding similar results. Our aim was to identify the prognostic factors for patient survival and for recurrence of hepatocellular carcinoma for patients within and beyond the Milan criteria...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301992/effect-of-downstaging-and-bridging-of-hepatocellular-carcinoma-on-survival-following-liver-transplant-a-single-center-experience
#19
Mohammed I Al Sebayel, Hussien Elsiesy, Waleed Al-Hamoudi, Saleh Alabbad, Yasser ElSheikh, Hany Elbeshbeshy, Isam Salih, Sarra Yousif, Yahia Saleh, Abdulmoneim Eldali, Faisal A Abaalkhail
OBJECTIVES: Hepatocellular carcinoma is among the leading causes of cancer death. The Milan criteria are the first and most widely used criteria for selecting patients with hepatocellular carcinoma for a good transplant outcome. Studies have shown that patients with hepatocellular carcinoma outside the Milan criteria have good outcomes if they are successfully downstaged before transplant. We report our experience with locoregional therapy for hepatocellular carcinoma, either for bridging or for downstaging prior to transplant...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28301991/new-developments-in-orthotopic-liver-transplant-for-hepatocellular-carcinoma
#20
Ignazio R Marino, Brian I Carr
The use of orthotopic liver transplant for hepatocellular carcinoma was a major advance, pioneered by Thomas E. Starzl as a way to circumvent the limitations imposed on the liver surgeon by the presence of cirrhosis and liver failure. Patients with a few small tumors, whatever their degree of liver damage, may expect prolonged survival (70% at 5 years). Patients with more advanced tumors have high recurrence rates and more limited survival, possibly due to immune suppression or pretransplant understaging of their tumors...
March 2017: Experimental and Clinical Transplantation
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