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The management of p...
The management of post-transplantation recurrence of hepatocellular carcinoma
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- Rajendran, Luckshi (författare)
- Univ Toronto, Div Gen Surg, Toronto, ON, Canada.
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- Ivanics, Tommy (författare)
- Uppsala universitet,Gastrointestinalkirurgi,Univ Hlth Network, Multiorgan Transplant Program, 585 Univ Ave,11PMB184, Toronto, ON M5G 2N2, Canada.;Henry Ford Hosp, Dept Surg, Detroit, MI 48202 USA
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- Claasen, Marco P. A. W. (författare)
- Univ Hlth Network, Multiorgan Transplant Program, 585 Univ Ave,11PMB184, Toronto, ON M5G 2N2, Canada.;Univ Med Ctr, Erasmus MC, Dept Surg, Rotterdam, Netherlands.
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- Muaddi, Hala (författare)
- Univ Toronto, Div Gen Surg, Toronto, ON, Canada.
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- Sapisochin, Gonzalo (författare)
- Univ Toronto, Div Gen Surg, Toronto, ON, Canada.;Univ Hlth Network, Multiorgan Transplant Program, 585 Univ Ave,11PMB184, Toronto, ON M5G 2N2, Canada.
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Univ Toronto, Div Gen Surg, Toronto, ON, Canada Gastrointestinalkirurgi (creator_code:org_t)
- The Korean Association for the Study of the Liver, 2022
- 2022
- Engelska.
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Ingår i: Clinical and Molecular Hepatology. - : The Korean Association for the Study of the Liver. - 2287-2728 .- 2287-285X. ; 28:1, s. 1-16
- Relaterad länk:
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https://doi.org/10.3...
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https://uu.diva-port... (primary) (Raw object)
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https://www.e-cmh.or...
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https://urn.kb.se/re...
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https://doi.org/10.3...
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Abstract
Ämnesord
Stäng
- The annual incidence of hepatocellular carcinoma (HCC) continues to rise. Over the last two decades, liver transplantation (LT) has become the preferable treatment of HCC, when feasible and strict selection criteria are met. With the rise in HCC-related LT, compounded by downstaging techniques and expansion of transplant selection criteria, a parallel increase in number of post-transplantation HCC recurrence is expected. Additionally, in the context of an immunosuppressed transplant host, recurrences may behave aggressively and more challenging to manage, resulting in poor prognosis. Despite this, no consensus or best practice guidelines for post-transplantation cancer surveillance and recurrence management for HCC currently exist. Studies with adequate population sizes and high-level evidence are lacking, and the role of systemic and locoregional therapies for graft and extrahepatic recurrences remains under debate. This review seeks to summarize the existing literature on post-transplant HCC surveillance and recurrence management. It highlights the value of early tumour detection, re-evaluating the immunosuppression regimen, and staging to differentiate disseminated recurrence from intrahepatic or extrahepatic oligo-recurrence. This ultimately guides decision-making and maximizes treatment effect. Treatment recommendations specific to recurrence type are provided based on currently available locoregional and systemic therapies.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Hepatocellular carcinoma
- Liver transplant
- Recurrence
- Immunosuppression
- Disease management
Publikations- och innehållstyp
- ref (ämneskategori)
- for (ämneskategori)
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