The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
Benefit of Initial Resection of Hepatocellular Carcinoma Followed by Transplantation in Case of Recurrence: An Intention–to–Treat Analysis
Open accessAbstract
Liver resection (LR) for hepatocellular carcinoma (HCC) as the first–line treatment in transplantable patients followed by “salvage transplantation” (ST) in case of recurrence is an attractive concept. The aim was to identify patients who gain benefit from this approach in an intention–to–treat study. From 1998 to 2008, among 329 potential candidates for liver transplantation (LT) with HCC within the Milan criteria (MC), 138 with good liver function were resected (LR group) from a perspective of ST in case of recurrence, and 191 were listed for LT first (LT group). The two groups were compared on an intention–to–treat basis with special reference to management of recurrences and transplantability after LR. Univariate and multivariate analyses were performed to identify resected patients who developed recurrence beyond MC. Five–year overall and disease–free survival was similar in both groups: LT versus LR group, 60% versus 77% and 56% versus 40%, respectively. Among the 138 patients in the LR group, 20 underwent LT before recurrence, 39 (28%) had ST, and 51 (37%) with recurrence were not transplanted including 21 within MC who were excluded for advanced age, acquired comorbidities, or refusal and 30 (22%) with recurrence beyond MC. Predictive factors for nontransplantability due to recurrence beyond MC included microscopic vascular invasion (hazard ratio [HR] 2.38 [range, 1.10–7.29]), satellite nodules (HR 2.46 [range, 1.01–6.68]), tumor size > 3 cm (HR 1.34 [range, 1.03–3.12]), poorly differentiated tumor (HR 3.18 [range, 1.31–7.70]), and liver cirrhosis (HR 1.90 [range, 1.04–3.12]). Conclusion : The high risk of failure of ST after initial LR for HCC within MC suggests the use of tissue analysis as a selection criterion. The salvage LT strategy should be restricted to patients with favorable oncological factors. (Hepatology 2012;;55:132–140)
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EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
Galle, P. R., Forner, A., Llovet, J. M., Mazzaferro, V., Piscaglia, F., Raoul, J.-L., Schirmacher, P., & Vilgrain, V. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2018.03.019 · Cited by 11,406
BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update
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Recurrence of Hepatocellular Cancer After Resection: Patterns, Treatments, and Prognosis
Tabrizian, P., Jibara, G., Shrager, B., Schwartz, M., & Roayaie, S. (2015) · Annals of Surgery · doi:10.1097/sla.0000000000000710 · Cited by 903
Metadata
- Authors
- Fuks, D., Dokmak, S., Paradis, V., Diouf, M., Durand, F., & Belghiti, J.
- Venue
- Hepatology
- Published
- 2012-01
- Volume
- 55
- Issue
- 1
- Pages
- 132-140
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2062484329
- Cited by
- 268
- References
- 30
- FWCI
- 15.29
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Fuks, D., Dokmak, S., Paradis, V., Diouf, M., Durand, F., & Belghiti, J. (2012). Benefit of Initial Resection of Hepatocellular Carcinoma Followed by Transplantation in Case of Recurrence: An Intention–to–Treat Analysis. Hepatology. https://doi.org/10.1002/hep.24680
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