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Treatment of recurrent hepatocellular carcinoma after liver transplantation

Authors
 Hye Ryun KIM  ;  Seong Ha CHEON  ;  Sun Young RHA  ;  Soohyeon LEE  ;  Kwang-Hyub HAN  ;  Chae Yoon CHON  ;  Jong Doo LEE  ;  Jin Sil SUNG  ;  Hyun Cheol CHUNG 
Citation
 ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Vol.7(3) : 258-269, 2011 
Journal Title
ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY
ISSN
 1743-7555 
Issue Date
2011
MeSH
Adult ; Aged ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/surgery ; Carcinoma, Hepatocellular/therapy* ; Female ; Humans ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Liver Neoplasms/therapy* ; Liver Transplantation/methods* ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/surgery ; Neoplasm Recurrence, Local/therapy* ; Palliative Care ; Retrospective Studies ; Survival Rate ; Treatment Outcome
Keywords
hepatocellular carcinoma ; liver transplantation ; palliative chemotherapy ; recurrence
Abstract
AIM: Liver transplantation (LT) is a curative treatment for localized hepatocellular carcinoma (HCC), but the recurrence rate after LT is about 10-20%, with a dismal prognosis. Little data exist as to the natural history, treatment outcome and optimal treatment of recurrent HCC after LT. We reviewed various treatment modalities given to patients with recurrent HCC after LT.

METHODS: Among 132 patients who underwent LT for localized HCC, we retrospectively reviewed medical records of 39 of the 132 patients who developed recurrent HCC after LT. We analyzed the clinical outcome of various treatment modalities and treatment-related adverse events.

RESULTS: A total of 39 (29%) of the original 132 patients had recurrent HCC, most recurrences (82%) having occurred within 1 year after LT and involved extrahepatic lesions. Only seven patients had recurrent disease limited to the liver. The median overall survival from the initial treatment of all relapsed patients was 6.9 months. There were various initial treatment modalities, namely palliative systemic chemotherapy, trans-catheter arterial chemo-embolization/infusion (TACE/I), radiation therapy (RT), surgical resection and no treatment. The median overall survival was 9.5 months for first-line chemotherapy, including those who had prior local therapy, 6.3 months TACE/I and 6.9 months for RT.

CONCLUSION: Various clinical approaches have been used to treat patients with recurrent HCC after LT in a clinical setting. More effective strategies and clinical guidelines for recurrent HCC following LT must be established.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1743-7563.2011.01425.x/abstract
DOI
10.1111/j.1743-7563.2011.01425.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hye Ryun(김혜련) ORCID logo https://orcid.org/0000-0002-1842-9070
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Lee, Soo Hyeon(이수현)
Lee, Jong Doo(이종두)
Cheon, Seong Ha(전성하)
Chon, Chae Yoon(전재윤)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93998
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