Tumor Characteristics and Long-Term Outcome of Incidental Hepatocellular Carcinoma After Orthotopic Liver Transplant

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Tumor Characteristics and Long-Term Outcome of Incidental Hepatocellular Carcinoma After Orthotopic Liver Transplant. / Mourad, Moustafa Mabrouk; Algarni, Abdullah; Aly, Menna-Allah; Gunson, Bridget K; Mergental, Hynek; Isaac, John; Muiesan, Paolo; Mirza, Darius; Perera, M Thamara P R; Bramhall, Simon R.

In: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, Vol. 13, No. 4, 08.2015, p. 333-8.

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Mourad, Moustafa Mabrouk ; Algarni, Abdullah ; Aly, Menna-Allah ; Gunson, Bridget K ; Mergental, Hynek ; Isaac, John ; Muiesan, Paolo ; Mirza, Darius ; Perera, M Thamara P R ; Bramhall, Simon R. / Tumor Characteristics and Long-Term Outcome of Incidental Hepatocellular Carcinoma After Orthotopic Liver Transplant. In: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation. 2015 ; Vol. 13, No. 4. pp. 333-8.

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@article{5b9974c4cc7c4247b26c9c9d4ab1e953,
title = "Tumor Characteristics and Long-Term Outcome of Incidental Hepatocellular Carcinoma After Orthotopic Liver Transplant",
abstract = "OBJECTIVES: Orthotopic liver transplant is the treatment of choice for hepatocellular carcinoma in cirrhotic patients with satisfactory oncologic and survival outcomes. Incidental hepatocellular carcinoma is frequently a reported finding in the explant pathology after orthotopic liver transplant.MATERIAL AND METHODS: The present study retrospectively analyzed the tumor characteristics and outcomes of 50 incidental hepatocellular carcinomas compared with 252 transplants for known hepatocellular carcinoma.RESULTS: Patients with incidental hepatocellular carcinoma had lower peak alpha-fetoprotein level (P = .001), lower pretransplant alpha-fetoprotein level (P = .002), smaller total tumor size (P = .0001), fewer tumor numbers (P = .0001), lower level of microvascular invasion (P = .001), more cases within Milan criteria (P = .005), and more well-differentiated tumors (P = .017). However, no difference in survival rates was observed between the 2 groups. In 35 patients (70%) who had incidental hepatocellular carcinoma, pretransplant imaging studies were normal; ultrasonography was used as the only screening tool in 25 of 35 patients (71%) who had incidental hepatocellular carcinoma, and 15 patients (30%) who had incidental hepatocellular carcinoma had regenerative or dysplastic nodules. The accuracy of ultrasonography in our unit for diagnosing hepatocellular carcinoma was 97.5%. A quarter of hepatitis B recipients had incidental hepatocellular carcinoma with a younger median recipient age. Tumor recurrence was higher with incidental hepatocellular carcinoma in hepatitis C recipients (22%). However, the overall recurrence was similar between all hepatitis and nonhepatitis recipients who were transplanted for incidental or known hepatocellular carcinoma.CONCLUSIONS: Incidental hepatocellular carcinoma has similar outcome as known hepatocellular carcinoma. Early screening of hepatitis B patients is recommended, and cross-sectional imaging is not mandatory for hepatocellular carcinoma screening in patients who are on the waiting list.",
author = "Mourad, {Moustafa Mabrouk} and Abdullah Algarni and Menna-Allah Aly and Gunson, {Bridget K} and Hynek Mergental and John Isaac and Paolo Muiesan and Darius Mirza and Perera, {M Thamara P R} and Bramhall, {Simon R}",
year = "2015",
month = aug,
language = "English",
volume = "13",
pages = "333--8",
journal = "Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation",
issn = "1304-0855",
publisher = "Baskent University",
number = "4",

}

RIS

TY - JOUR

T1 - Tumor Characteristics and Long-Term Outcome of Incidental Hepatocellular Carcinoma After Orthotopic Liver Transplant

AU - Mourad, Moustafa Mabrouk

AU - Algarni, Abdullah

AU - Aly, Menna-Allah

AU - Gunson, Bridget K

AU - Mergental, Hynek

AU - Isaac, John

AU - Muiesan, Paolo

AU - Mirza, Darius

AU - Perera, M Thamara P R

AU - Bramhall, Simon R

PY - 2015/8

Y1 - 2015/8

N2 - OBJECTIVES: Orthotopic liver transplant is the treatment of choice for hepatocellular carcinoma in cirrhotic patients with satisfactory oncologic and survival outcomes. Incidental hepatocellular carcinoma is frequently a reported finding in the explant pathology after orthotopic liver transplant.MATERIAL AND METHODS: The present study retrospectively analyzed the tumor characteristics and outcomes of 50 incidental hepatocellular carcinomas compared with 252 transplants for known hepatocellular carcinoma.RESULTS: Patients with incidental hepatocellular carcinoma had lower peak alpha-fetoprotein level (P = .001), lower pretransplant alpha-fetoprotein level (P = .002), smaller total tumor size (P = .0001), fewer tumor numbers (P = .0001), lower level of microvascular invasion (P = .001), more cases within Milan criteria (P = .005), and more well-differentiated tumors (P = .017). However, no difference in survival rates was observed between the 2 groups. In 35 patients (70%) who had incidental hepatocellular carcinoma, pretransplant imaging studies were normal; ultrasonography was used as the only screening tool in 25 of 35 patients (71%) who had incidental hepatocellular carcinoma, and 15 patients (30%) who had incidental hepatocellular carcinoma had regenerative or dysplastic nodules. The accuracy of ultrasonography in our unit for diagnosing hepatocellular carcinoma was 97.5%. A quarter of hepatitis B recipients had incidental hepatocellular carcinoma with a younger median recipient age. Tumor recurrence was higher with incidental hepatocellular carcinoma in hepatitis C recipients (22%). However, the overall recurrence was similar between all hepatitis and nonhepatitis recipients who were transplanted for incidental or known hepatocellular carcinoma.CONCLUSIONS: Incidental hepatocellular carcinoma has similar outcome as known hepatocellular carcinoma. Early screening of hepatitis B patients is recommended, and cross-sectional imaging is not mandatory for hepatocellular carcinoma screening in patients who are on the waiting list.

AB - OBJECTIVES: Orthotopic liver transplant is the treatment of choice for hepatocellular carcinoma in cirrhotic patients with satisfactory oncologic and survival outcomes. Incidental hepatocellular carcinoma is frequently a reported finding in the explant pathology after orthotopic liver transplant.MATERIAL AND METHODS: The present study retrospectively analyzed the tumor characteristics and outcomes of 50 incidental hepatocellular carcinomas compared with 252 transplants for known hepatocellular carcinoma.RESULTS: Patients with incidental hepatocellular carcinoma had lower peak alpha-fetoprotein level (P = .001), lower pretransplant alpha-fetoprotein level (P = .002), smaller total tumor size (P = .0001), fewer tumor numbers (P = .0001), lower level of microvascular invasion (P = .001), more cases within Milan criteria (P = .005), and more well-differentiated tumors (P = .017). However, no difference in survival rates was observed between the 2 groups. In 35 patients (70%) who had incidental hepatocellular carcinoma, pretransplant imaging studies were normal; ultrasonography was used as the only screening tool in 25 of 35 patients (71%) who had incidental hepatocellular carcinoma, and 15 patients (30%) who had incidental hepatocellular carcinoma had regenerative or dysplastic nodules. The accuracy of ultrasonography in our unit for diagnosing hepatocellular carcinoma was 97.5%. A quarter of hepatitis B recipients had incidental hepatocellular carcinoma with a younger median recipient age. Tumor recurrence was higher with incidental hepatocellular carcinoma in hepatitis C recipients (22%). However, the overall recurrence was similar between all hepatitis and nonhepatitis recipients who were transplanted for incidental or known hepatocellular carcinoma.CONCLUSIONS: Incidental hepatocellular carcinoma has similar outcome as known hepatocellular carcinoma. Early screening of hepatitis B patients is recommended, and cross-sectional imaging is not mandatory for hepatocellular carcinoma screening in patients who are on the waiting list.

M3 - Article

C2 - 26295183

VL - 13

SP - 333

EP - 338

JO - Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

JF - Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

SN - 1304-0855

IS - 4

ER -