4.5 Review

The management of post-transplantation recurrence of hepatocellular carcinoma

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Summary: This paper comprehensively reviews the data on assessing risk and managing recurrence for patients undergoing liver transplantation for hepatocellular carcinoma (HCC). Multiple post-transplant prognostic scoring systems have been developed to improve recurrence risk assessment, but translating this information into surveillance and treatment strategies remains a challenge. Immunosuppression strategies post-LT aim to reduce recurrence risk, while evidence-based strategies for managing recurrent HCC are continuously evolving.

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Summary: IRE, as a nonthermal ablative technique, may reduce the risk of abscess development and preserve perilesional blood vessels in the treatment of post-transplant intrahepatic HCC recurrence. This technique has been effective in treating such cases.

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Bryan Cho Wing Li et al.

Summary: Treatment of hepatocellular carcinoma recurrences following liver transplant is challenging, with early recurrence within 1 year from transplant being the most significant risk factor. Sorafenib is the preferred systemic therapy, with comparable efficacy, adverse events, and tolerability to advanced HCC without transplant.

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Minjeong Kim et al.

Summary: The study identified several risk factors associated with poor survival after hepatocellular carcinoma recurrence following liver transplantation, including graft from living donor, recurrence-free interval of >= 9 months, alpha-fetoprotein of >= 100 ng/mL at the time of recurrence, recurrence in bone, and everolimus within 3 months after recurrence.

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