Evidence map›Paper›PMID 32655233›Full record

ArticleJournal of clinical and experimental hepatology

Predictors, Presentation, and Treatment Outcomes of Recurrent Hepatocellular Carcinoma After Liver Transplantation: A Large Single Center Experience.

Sirina Ekpanyapong, Neil Philips, Bao-Li Loza, Peter Abt, Emma E Furth, Rashmi Tondon, Vandana Khungar, Kim Olthoff, Abraham Shaked, Maarouf A Hoteit and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Review
  6. Review
  7. Observational
  8. Review
  9. SirolimusWorld journal of gastrointestinal surgery · 2022
    Article
  10. Non-transplantable Recurrence After Resection for Transplantable Hepatocellular Carcinoma: Implication for Upfront Treatment Choice.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022
    Article
  11. Review
  12. The Landscape Of Alpha Fetoprotein In Hepatocellular Carcinoma: Where Are We?International journal of biological sciences · 2022
    Review
  13. Review
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sirina EkpanyapongDepartment of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
Neil PhilipsDepartment of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
Bao-Li LozaDepartment of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA, USA.
Peter AbtDepartment of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA, USA.
Emma E FurthDepartment of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Rashmi TondonDepartment of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Vandana KhungarDepartment of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
Kim OlthoffDepartment of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA, USA.
Abraham ShakedDepartment of Surgery, Penn Transplant Institute, University of Pennsylvania, Philadelphia, PA, USA.
Maarouf A HoteitDepartment of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
K Rajender ReddyDepartment of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLiver transplantation (LT) is an accepted therapeutic option for hepatocellular carcinoma (HCC) in patients with cirrhosis. Despite careful candidate selection, HCC recurrence occurs. We aimed to describe the predictors of recurrence, clinical presentation, and predictors of survival after HCC recurrence post-LT.

methodsPatients with recurrent HCC after LT between January 1996 and December 2017 were retrospectively reviewed.

resultsOf 711 patients, 96 (13.5%) patients had post-LT HCC recurrence. The median time to recurrence was 17.1 months, and the median survival was 10.1 months. Initial recurrence was more often in the graft (34.4%), and most (60.4%) had multiple recurrent lesions, and 26% were in multiple sites. In multivariate analysis, factors associated with shorter survival were poorly differentiated histology in explant (Hazard ratio [HR] = 1.96; p = 0.027), bilirubin ≥1.2 mg/dL (HR = 2.47; p = 0.025), and albumin <3.5 mg/dL (HR = 2.13; p = 0.014) at recurrence, alpha-fetoprotein at recurrence ≥ 1000 ng/mL (HR = 2.96; p = 0.005), and peritoneal disease (HR = 3.20; p = 0.022). There was an increased survival in patients exposed to sirolimus (HR = 0.32; p < 0.0001).

conclusionsRecurrent HCC after LT is often in extrahepatic sites with a decreased survival in those with poorly differentiated explant pathology, high bilirubin, low albumin, marked elevation of alpha-fetoprotein at recurrence, and peritoneal recurrence. Sirolimus-based immunosuppression may provide benefit.

Indexed as

AFP, alpha-fetoproteinALP, alkaline phosphataseALT, alanine transaminaseCNI, calcineurin inhibitorCT, computed tomographyHBV, hepatitis B virusHCC, hepatocellular carcinomaHCV, hepatitis C virushepatocellular carcinomaimmunosuppressionINR, international normalized ratioliver transplantationLT, Liver transplantationMRI, magnetic resonance imagingmTOR, mammalian target of rapamycinNASH, nonalcoholic steatohepatitisrecurrenceRETREAT, Risk Estimation of Tumor Recurrence After TransplantRFA, radiofrequency ablationsurvivalTACE, transarterial chemoembolizationUCSF, University of California San FranciscoUNOS, United Network for Organ Sharing

Identifiers

PMID32655233
PMCPMC7335705

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.