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Type: Artigo
Title: Hepatocellular carcinoma recurrence after liver transplantation in a brazilian multicenter study : clinical profile and prognostic factors of survival
Author: Chagas, Aline L.
Felga, Guilherme E. G.
Diniz, Marcio A.
Silva, Renato F.
Mattos, Angelo A.
Silva, Rita C. M. A.
Boin, Ilka F. S. F.
Garcia, Jose H. P.
Lima, Agnaldo S.
Coelho, Julio C. U.
Bittencourt, Paulo L.
Alves, Venancio A. F.
D'Albuquerque, Luiz A. C.
Carrilho, Flair J.
Chagas, Mine
Onishi Kikuchi, Luciana Oba
Carneiro D'Aibuquerque, Luiz Augusto
Carrilho, Flair Jose
Goncalves Felga, Guilherme Eduardo
de Almeida, Marcio Dias
Martins Alves da Silva, Rita de Cassia
da Silva, Renato Ferreira
Possato, Mariana Bina
Santana Ferreira Boin, Ilka de Fatima
Zanotelli, Maria Lucia
Arantes Ferreira, Gustavo de Sousa
Uili Coelho, Julio Cezar
Garcia Costa, Paulo Everton
Parente Garcia, Jose Huygens
Reichert, Paulo
Lisboa Bittencourt, Paulo
Sandoli Baia, Carlos Eduardo
Benedita Terrabuio, Debora Raquel
Foinquinos, Gabriela
Rampche de Carvalho, Sylene Coutinho
Moreira Beltrao Pereira, Leila Maria
Pereira de Moraes, Adriano Claudio
Conde Watanabe, Andre Luis
Lima, Agnaldo Soares
de Mattos, Angelo Alves
Abstract: Liver transplantation (LT) is the treatment of choice for patients with unresectable early hepatocellular carcinoma (HCC). Post-LT HCC recurrence rates range from 8 to 20% and still impact on overall survival (OS). The aim of our study was to evaluate the impact of HCC recurrence on post-LT survival and analyze prognostic factors among those patients with recurrence. We carried out a national, multicenter, retrospective cohort study in Brazil. Medical records of 1119 LT recipients with HCC were collected. Data from patients with post-LT HCC recurrence were analyzed and correlated with post-relapse survival. OS of the 1119 patients included in the study was 63% over 5 years. Post-LT HCC recurrence occurred in 86 (8%) patients. The mean time to recurrence was 12 months. Sites of recurrence were extrahepatic in 55%, hepatic in 27%, and both hepatic and extrahepatic in 18%. Recurrence treatment was performed in 50 (64%) cases, mostly with sorafenib. Post-relapse survival rates were 34% at 1 year and 13% at 5 years. Univariable analysis identified alpha-fetoprotein more than 1000 ng/ml at relapse, recurrence treatment, extrahepatic location, and time to recurrence more than 2 years as prognostic factors. In multivariable analysis, recurrence treatment, extrahepatic location, and time to recurrence more than 2 years were independent predictors of better survival. In a large Brazilian cohort of LT recipients with HCC, post-LT HCC recurrence occurred in 8% and impacted significantly on the OS. Patients with early recurrence presented a worse prognosis. However, treatment of recurrence improved outcomes, highlighting the importance of early diagnosis
Subject: Fígado - Câncer
Country: Estados Unidos
Editor: Lippincott Williams & Wilkins
Rights: Fechado
Identifier DOI: 10.1097/MEG.0000000000001448
Date Issue: 2019
Appears in Collections:FCM - Artigos e Outros Documentos

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