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Cited by 297

The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.

High pathological risk of recurrence after surgical resection for hepatocellular carcinoma: An indication for salvage liver transplantation

Open access
Sala, Margarita, Fuster, Josep, Llovet, Josep M., Navasa, Miquel, Solé, Manel, Varela, María, Pons, Fernando, Rimola, Antoni, García-Valdecasas, Juan Carlos, Brú, Concepció, Bruix, Jordi·2004·Liver Transplantation
DOI 10.1002/lt.20202
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Abstract

Surgical resection and liver transplantation offer a 5-year survival greater than 70% in patients with hepatocellular carcinoma, but the high recurrence rate impairs long-term outcome after resection. Pathological data such as vascular invasion and detection of additional nodules predict recurrence and divide patients into high and low risk profile. Based on this, we proposed salvage liver transplant to resected patients in whom pathology evidenced high recurrence risk even in the absence of proven residual disease. From January 1995 to August 2003 we have evaluated 1,638 patients. Resection was indicated in 77 patients, but only 17 (22%) (all cirrhotics, 14 hepatitis C virus+) were optimal candidates for both resection and transplantation. Of them, 8 exhibited a high risk profile at pathology and were offered transplantation. Among the 8 high risk patients, 7 presented recurrence, compared with only 2 of the 9 at low risk (P = .012). Two of the high risk patients refused transplant and developed multifocal disease during follow-up. The other 6 were enlisted and all but 1 had tumor foci in the explant. Only 1 presented extrahepatic dissemination early after transplant and died 4 months later. The others are free of disease after a median follow-up of 45 months. Two recurrences were detected in low risk patients, 1 of them being transplanted 18 months after surgery. These data in a small series of patients confirm that pathological parameters identify patients at higher risk of recurrence, which allow them to be listed for liver transplantation without proven malignant disease. In conclusion, this policy is clinically effective and could further improve the outcome of resected patients. (Liver Transpl 2004;10:1294-1300.)

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Metadata

Authors
Sala, M., Fuster, J., Llovet, J. M., Navasa, M., Solé, M., Varela, M., Pons, F., Rimola, A., García-Valdecasas, J. C., Brú, C., & Bruix, J.
Venue
Liver Transplantation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-10
Volume
10
Issue
10
Pages
1294-1300
ISSN
1527-6465 (ISSN-L)
DOI
10.1002/lt.20202
OpenAlex
W2007624969
Cited by
297
References
34
FWCI
10.09
Type
journal article
Language
en
Open access
bronze

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