https://observatorio.fm.usp.br/handle/OPI/34549
Title: | Hepatocellular carcinoma recurrence after liver transplantation in a Brazilian multicenter study: clinical profile and prognostic factors of survival |
Authors: | CHAGAS, Aline L.; FELGA, Guilherme E. G.; DINIZ, Marcio A.; SILVA, Renato F.; MATTOS, Angelo A.; SILVA, Rita C. M. A.; BOIN, Ilka F. S. F.; GARCIA, Jose H. P.; LIMA, Agnaldo S.; COELHO, Julio C. U.; BITTENCOURT, Paulo L.; ALVES, Venancio A. F.; CHAGAS, Mine; KIKUCHI, Luciana Oba Onishi; D'AIBUQUERQUE, Luiz Augusto Carneiro; CARRILHO, Flair Jose; FELGA, Guilherme Eduardo Goncalves; ALMEIDA, Marcio Dias de; SILVA, Rita de Cassia Martins Alves da; SILVA, Renato Ferreira da; POSSATO, Mariana Bina; BOIN, Ilka de Fatima Santana Ferreira; ZANOTELLI, Maria Lucia; FERREIRA, Gustavo de Sousa Arantes; COELHO, Julio Cezar Uili; COSTA, Paulo Everton Garcia; GARCIA, Jose Huygens Parente; REICHERT, Paulo; BITTENCOURT, Paulo Lisboa; BAIA, Carlos Eduardo Sandoli; TERRABUIO, Debora Raquel Benedita; FOINQUINOS, Gabriela; CARVALHO, Sylene Coutinho Rampche de; PEREIRA, Leila Maria Moreira Beltrao; MORAES, Adriano Claudio Pereira de; WATANABE, Andre Luis Conde; LIMA, Agnaldo Soares; MATTOS, Angelo Alves de |
Citation: | EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, v.31, n.9, p.1148-1156, 2019 |
Abstract: | Background Liver transplantation (LT) is the treatment of choice for patients with unresectable early hepatocellular carcinoma (HCC). Post-LT HCC recurrence rates range from 8 to 20% and still impact on overall survival (OS). The aim of our study was to evaluate the impact of HCC recurrence on post-LT survival and analyze prognostic factors among those patients with recurrence. Patients and methods We carried out a national, multicenter, retrospective cohort study in Brazil. Medical records of 1119 LT recipients with HCC were collected. Data from patients with post-LT HCC recurrence were analyzed and correlated with post-relapse survival. Results OS of the 1119 patients included in the study was 63% over 5 years. Post-LT HCC recurrence occurred in 86 (8%) patients. The mean time to recurrence was 12 months. Sites of recurrence were extrahepatic in 55%, hepatic in 27%, and both hepatic and extrahepatic in 18%. Recurrence treatment was performed in 50 (64%) cases, mostly with sorafenib. Post-relapse survival rates were 34% at 1 year and 13% at 5 years. Univariable analysis identified alpha-fetoprotein more than 1000 ng/ml at relapse, recurrence treatment, extrahepatic location, and time to recurrence more than 2 years as prognostic factors. In multivariable analysis, recurrence treatment, extrahepatic location, and time to recurrence more than 2 years were independent predictors of better survival. Conclusion In a large Brazilian cohort of LT recipients with HCC, post-LT HCC recurrence occurred in 8% and impacted significantly on the OS. Patients with early recurrence presented a worse prognosis. However, treatment of recurrence improved outcomes, highlighting the importance of early diagnosis. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MGT Artigos e Materiais de Revistas Científicas - FM/MPT Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - LIM/07 Artigos e Materiais de Revistas Científicas - LIM/14 Artigos e Materiais de Revistas Científicas - LIM/37 Artigos e Materiais de Revistas Científicas - ODS/03 |
File | Description | Size | Format | |
---|---|---|---|---|
art_CHAGAS_Hepatocellular_carcinoma_recurrence_after_liver_transplantation_in_a_2019.PDF Restricted Access | publishedVersion (English) | 477.11 kB | Adobe PDF | View/Open Request a copy |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.