ReviewTranslational gastroenterology and hepatology2017
Downstaging for hepatocellular cancer: harm or benefit?
Review in Translational gastroenterology and hepatology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Selective internal radiation therapies for unresectable early-, intermediate- or advanced-stage hepatocellular carcinoma: systematic review, network meta-analysis and economic evaluation.Health technology assessment (Winchester, England) · 2020Pooled it
- Arterial Complications in Patients Undergoing Liver Transplantation After Previous TACE Treatment.Journal of clinical medicine · 2025Article
- Biodegradable Microspheres for Transarterial Chemoembolization in Malignant Liver Disease.Medicina (Kaunas, Lithuania) · 2024Review
- Retrospective Long-Term Evaluation of Conventional Transarterial Chemoembolization for Hepatocellular Carcinoma over 20 Years.Cancers · 2024Article
- Article
- Bridging and downstaging with TACE in early and intermediate stage hepatocellular carcinoma: Predictors of receiving a liver transplant.Annals of gastroenterological surgery · 2023Article
- Review
- Selecting the Best Approach for the Treatment of Multiple Non-Metastatic Hepatocellular Carcinoma.Cancers · 2022Review
- Review
- Liver transplantation in hepatocellular carcinoma - should we perform downstaging?Croatian medical journal · 2022Article
- Article
- Trans-arterial chemoembolization as a loco-regional inducer of immunogenic cell death in hepatocellular carcinoma: implications for immunotherapy.Journal for immunotherapy of cancer · 2021Article
- Indication of Liver Transplantation for Hepatocellular Carcinoma Should Be Reconsidered in Case of Microvascular Invasion and Multilocular Tumor Occurrence.Journal of clinical medicine · 2021Article
- Safety and Efficacy of Degradable Starch Microspheres Transcatheter Arterial Chemoembolization (DSM-TACE) in the Downstaging of Intermediate-Stage Hepatocellular Carcinoma (HCC) in Patients With a Child-Pugh Score of 8-9.Frontiers in pharmacology · 2021Article
- Drug-eluting beads-transarterial chemoembolization plus microwave ablation is an effective and safe treatment strategy in treating hepatocellular carcinoma adjacent to gallbladder.American journal of translational research · 2021Article
- What Should Be the Rules for Downstaging for Hepatocellular Carcinoma?Journal of gastrointestinal cancer · 2020Review
- The Timing of Liver Transplantation Following Downstaging: Wait of Not to Wait?Journal of gastrointestinal cancer · 2020Review
- Embolotherapy for Hepatic Oncology: Current Perspectives and Future Directions.Digestive disease interventions · 2020Article
- Liver Transplantation Beyond Milan Criteria.Journal of clinical and translational hepatology · 2020Review
- Survival After Treatable Hepatocellular Carcinoma Recurrence in Liver Recipients: A Nationwide Cohort Analysis.Frontiers in oncology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Downstaging of hepatocellular carcinoma (HCC) to enable liver transplantation has become an area of intense interest and research. It may allow a curative option in patients outside widely accepted transplantation criteria, with outcomes that, in some studies, are comparable to transplantation for patients within criteria. There have been conflicting opinions on the best downstaging protocols, criteria for downstaging eligibility and for assessment of response. We therefore aimed to review the literature and evidence for downstaging, as well as considering its drawbacks.
conclusionPooled analyses have suggested success in down staging in about half of patients treated, but with higher recurrence rates than patients initially within transplantation criteria. Studies with strict inclusion criteria and mandatory waiting time before transplantation reported survival equivalent to patients who did not require downstaging. In carefully selected patients, there is a role for down staging to provide the chance of transplantation and cure, with acceptable outcomes. Further multi center, well-designed studies are required to clarify who will mostly benefit. Until such data is available, downstaging criteria should be stated within transplantation programs and relevant decisions should be discussed by multidisciplinary teams.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.