Evidence map›Paper›PMID 33839747›Full record

Trial reportBJS open2021

Hepatocellular carcinoma progression during bridging before liver transplantation.

P Renner, T Da Silva, A A Schnitzbauer, N Verloh, H J Schlitt, E K Geissler

Abstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing 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

8 citing papers in PubMed.

  1. Improving surgical treatments for hepatocellular carcinoma.Nature reviews. Gastroenterology & hepatology · 2026
    Review
  2. Review
  3. Review
  4. Review
  5. Article
  6. [Influence of molecular pathology on oncological surgery of liver and bile duct tumors].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021
    Review
  7. Liver transplantation in malignant disease.World journal of clinical oncology · 2021
    Review
  8. 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

6 authors.

P RennerDepartment of Surgery, University Medical Centre Regensburg, Regensburg, Germany.
T Da SilvaDepartment of Surgery, University Medical Centre Regensburg, Regensburg, Germany.
A A SchnitzbauerDepartment for General, Visceral and Transplant Surgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany.
N VerlohDepartment of Radiology, University Medical Centre Regensburg, Regensburg, Germany.
H J SchlittDepartment of Surgery, University Medical Centre Regensburg, Regensburg, Germany.
E K GeisslerDepartment of Surgery, University Medical Centre Regensburg, Regensburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecipient selection for liver transplantation in hepatocellular carcinoma (HCC) is based primarily on criteria affecting the chance of long-term success. Here, the relationship between pretransplant bridging therapy and long-term survival was investigated in a subgroup analysis of the SiLVER Study.

methodsResponse to bridging, as defined by comparison of imaging at the time of listing and post-transplant pathology report, was categorized into controlled versus progressive disease (more than 20 per cent tumour growth or development of new lesions).

resultsOf 525 patients with HCC who had liver transplantation, 350 recipients underwent pretransplant bridging therapy. Tumour progression despite bridging was an independent risk factor affecting overall survival (hazard ratio 1.80; P = 0.005). For patients within the Milan criteria (MC) at listing, mean overall survival was longer for those with controlled versus progressive disease (6.8 versus 5.8 years; P < 0.001). Importantly, patients with HCCs outside the MC that were downsized to within the MC before liver transplantation had poor outcomes compared with patients who never exceeded the MC (mean overall survival 6.2 versus 6.6 years respectively; P = 0.030).

conclusionPatients with HCCs within the MC that did not show tumour progression under locoregional therapy had the best outcomes after liver transplantation. Downstaging into the limits of the MC did not improve the probability of survival.Prognostic factors determining the long-term success of liver transplantation in patients with hepatocellular carcinoma are still under discussion. A subgroup analysis of the SiLVER trial showed that disease control under bridging therapy is strongly associated with improved prognosis in terms of overall survival. However, in tumours exceeding the limits of the Milan criteria, downstaging did not restore the probability of survival compared with that of patients within the Milan criteria.

Indexed as

Carcinoma, HepatocellularDisease ProgressionFemaleHumansLiver NeoplasmsLiver TransplantationMaleMiddle AgedMultivariate AnalysisNeoplasm Recurrence, LocalPrognosisRisk FactorsSurvival AnalysisTime FactorsTreatment OutcomeWaiting Lists

Identifiers

PMID33839747
PMCPMC8038254

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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.