Optimal Tailored Screening Protocol after Living Donor Liver Transplantation for Hepatocellular Carcinoma
The indication for hepatocellular carcinoma (HCC) is expanding in living donor liver transplantation (LDLT). Early detection and effective management of recurrence has become an important issue in LDLT for HCC. This study aimed to find an optimal screening protocol in terms of screening interval and...
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The Korean Academy of Medical Sciences
2014
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214935/ |
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pubmed-42149352014-11-03 Optimal Tailored Screening Protocol after Living Donor Liver Transplantation for Hepatocellular Carcinoma Park, Min-Su Lee, Kwang-Woong Yi, Nam-Joon Choi, Young Rok Kim, Hyeyoung Hong, Geun Suh, Kyung-Suk Kwon, Choon-Hyuck David Joh, Jae-Won Lee, Suk-Koo Original Article The indication for hepatocellular carcinoma (HCC) is expanding in living donor liver transplantation (LDLT). Early detection and effective management of recurrence has become an important issue in LDLT for HCC. This study aimed to find an optimal screening protocol in terms of screening interval and screening tools by analyzing recurrence pattern after LDLT for HCC. A total of 205 LDLT patients in two centers from February 1999 to October 2010 was reviewed. Recurrence appeared in 55 cases. Six risk factors for recurrence were identified: preoperative alpha-fetoprotein >400, Edmonson grade 3 or 4, tumor size >7 cm, tumor number ≥7, minimal tumor necrosis in the transarterial chemoembolization group and positive micro-vascular invasion. Four groups with different ranges of index scores showed different recurrence-free survival and median time to recurrence. Group I showed low and late recurrence. Groups II and III showed linearly increased rate of recurrence until 18 months. Group IV showed very early recurrence within 6 months. Across the groups, extra-hepatic recurrence developed in more than 40% of cases and multi-organ recurrence rate was 20%. The screening interval should be different based on the risk of recurrence. Screening should include work-up for extra-hepatic recurrence as well as intra-hepatic recurrence. The Korean Academy of Medical Sciences 2014-10 2014-10-08 /pmc/articles/PMC4214935/ /pubmed/25368488 http://dx.doi.org/10.3346/jkms.2014.29.10.1360 Text en © 2014 The Korean Academy of Medical Sciences. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Park, Min-Su Lee, Kwang-Woong Yi, Nam-Joon Choi, Young Rok Kim, Hyeyoung Hong, Geun Suh, Kyung-Suk Kwon, Choon-Hyuck David Joh, Jae-Won Lee, Suk-Koo |
| spellingShingle |
Park, Min-Su Lee, Kwang-Woong Yi, Nam-Joon Choi, Young Rok Kim, Hyeyoung Hong, Geun Suh, Kyung-Suk Kwon, Choon-Hyuck David Joh, Jae-Won Lee, Suk-Koo Optimal Tailored Screening Protocol after Living Donor Liver Transplantation for Hepatocellular Carcinoma |
| author_facet |
Park, Min-Su Lee, Kwang-Woong Yi, Nam-Joon Choi, Young Rok Kim, Hyeyoung Hong, Geun Suh, Kyung-Suk Kwon, Choon-Hyuck David Joh, Jae-Won Lee, Suk-Koo |
| author_sort |
Park, Min-Su |
| title |
Optimal Tailored Screening Protocol after Living Donor Liver Transplantation for Hepatocellular Carcinoma |
| title_short |
Optimal Tailored Screening Protocol after Living Donor Liver Transplantation for Hepatocellular Carcinoma |
| title_full |
Optimal Tailored Screening Protocol after Living Donor Liver Transplantation for Hepatocellular Carcinoma |
| title_fullStr |
Optimal Tailored Screening Protocol after Living Donor Liver Transplantation for Hepatocellular Carcinoma |
| title_full_unstemmed |
Optimal Tailored Screening Protocol after Living Donor Liver Transplantation for Hepatocellular Carcinoma |
| title_sort |
optimal tailored screening protocol after living donor liver transplantation for hepatocellular carcinoma |
| description |
The indication for hepatocellular carcinoma (HCC) is expanding in living donor liver transplantation (LDLT). Early detection and effective management of recurrence has become an important issue in LDLT for HCC. This study aimed to find an optimal screening protocol in terms of screening interval and screening tools by analyzing recurrence pattern after LDLT for HCC. A total of 205 LDLT patients in two centers from February 1999 to October 2010 was reviewed. Recurrence appeared in 55 cases. Six risk factors for recurrence were identified: preoperative alpha-fetoprotein >400, Edmonson grade 3 or 4, tumor size >7 cm, tumor number ≥7, minimal tumor necrosis in the transarterial chemoembolization group and positive micro-vascular invasion. Four groups with different ranges of index scores showed different recurrence-free survival and median time to recurrence. Group I showed low and late recurrence. Groups II and III showed linearly increased rate of recurrence until 18 months. Group IV showed very early recurrence within 6 months. Across the groups, extra-hepatic recurrence developed in more than 40% of cases and multi-organ recurrence rate was 20%. The screening interval should be different based on the risk of recurrence. Screening should include work-up for extra-hepatic recurrence as well as intra-hepatic recurrence. |
| publisher |
The Korean Academy of Medical Sciences |
| publishDate |
2014 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214935/ |
| _version_ |
1613150621061349376 |