Liver transplantation in patients with incidental hepatocellular carcinoma/cholangiocarcinoma and intrahepatic cholangiocarcinoma: a single-center experience

Autor: Christopher P. Coppa, Daniel J. Firl, Mohammed Elshamy, Federico Aucejo, Naftali Presser, John J. Fung, Abdulrahman Y. Hammad
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Carcinoma
Hepatocellular
Time Factors
Databases
Factual
medicine.medical_treatment
Biopsy
Kaplan-Meier Estimate
Liver transplantation
Single Center
Gastroenterology
Disease-Free Survival
Cholangiocarcinoma
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Carcinoma
Humans
neoplasms
Intrahepatic Cholangiocarcinoma
Early Detection of Cancer
Aged
Ohio
Hepatology
medicine.diagnostic_test
business.industry
Liver Neoplasms
Perioperative
Middle Aged
medicine.disease
Neoplasms
Complex and Mixed
digestive system diseases
Liver Transplantation
Transplantation
Treatment Outcome
Bile Duct Neoplasms
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Disease Progression
030211 gastroenterology & hepatology
Female
Neoplasm Recurrence
Local
business
Zdroj: Hepatobiliarypancreatic diseases international : HBPD INT. 16(3)
ISSN: 1499-3872
Popis: Background Reports of liver transplantation (LT) in patients with mixed hepatocellular carcinoma/cholangiocarcinoma (HCC/CC) and intrahepatic cholangiocarcinoma (ICC) are modest and have been mostly retrospective after pathological categorization in the setting of presumed HCC. Some studies suggest that patients undergoing LT with small and unifocal ICC or mixed HCC/CC can achieve about 40%–60% 5-year post-transplant survival. The study aimed to report our experience in patients undergoing LT with explant pathology revealing HCC/CC and ICC. Methods From a prospectively maintained database, we performed cohort analysis. We identified 13 patients who underwent LT with explant pathology revealing HCC/CC or ICC. Results The observed recurrence rate post-LT was 31% (4/13) and overall survival was 85%, 51%, and 51% at 1, 3 and 5 years, respectively. Disease-free survival was 68%, 51%, and 41% at 1, 3 and 5 years, respectively. In our cohort, four patients would have qualified for exception points based on updated HCC Organ Procurement and Transplantation Network imaging guidelines. Conclusions Lesions which lack complete imaging characteristics of HCC may warrant pre-LT biopsy to fully elucidate their pathology. Identified patients with early HCC/CC or ICC may benefit from LT if unresectable. Additionally, incorporating adjunctive perioperative therapies such as in the case of patients undergoing LT with hilar cholangiocarcinoma may improve outcomes but this warrants further investigation.
Databáze: OpenAIRE
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