☆ 4.8 Review

Are patients with hepatocellular carcinoma and portal vein tumour thrombosis candidates for liver transplantation?

JOURNAL OF HEPATOLOGY (2023)

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Proton beam therapy to bridge or downstage locally advanced hepatocellular carcinoma to living donor liver transplantation

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Long-term outcomes of deceased donor liver transplantation in hepatocellular carcinoma patients with portal vein tumor thrombus: A multicenter study

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Summary: Deceased donor liver transplantation (DDLT) may be a viable treatment option for hepatocellular carcinoma (HCC) patients with type 1 or 2 portal vein tumor thrombus (PVTT). Preoperative alpha-fetoprotein (AFP) levels should be considered in selecting PVTT patients for DDLT to achieve better treatment outcomes.

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Summary: This study reported outcomes in HCC patients who underwent LDLT outside traditional criteria, including MVI. Results showed acceptable survival can be achieved with LDLT for HCC when considering factors such as AFP levels, response to downstaging, and degree of MVI.

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Summary: HCC is one of the most common and deadliest cancers globally. Immuno-oncology has shown promising results in the treatment of HCC, with immune checkpoint inhibition becoming the first-line therapy for advanced cases. However, challenges remain in determining the role of immunotherapy in earlier stages of HCC and identifying treatment strategies for non-responsive patients.

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BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update

Maria Reig et al.

Summary: There have been significant advances in the treatment strategies for hepatocellular carcinoma since the last update in 2018. However, some interventions still lack sufficient data for clinical incorporation, and personalized clinical management requires consideration of multiple parameters.

JOURNAL OF HEPATOLOGY (2022)

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Review Oncology

Immune Checkpoint Inhibitor Use in Solid Organ Transplant Recipients: A Systematic Review

Andrew J. Portuguese et al.

Summary: The use of immune checkpoint inhibitor (ICI) therapy in solid organ transplant recipients (SOTRs) with cancer can lead to objective responses, but also carries risks of rejection and immune-related adverse events. Treatment decisions in this population require careful consideration of benefits and risks, and close coordination between medical oncologists and transplant specialists to optimize outcomes.

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Stereotactic body radiotherapy plus transcatheter arterial chemoembolization for inoperable hepatocellular carcinoma patients with portal vein tumour thrombus: A meta-analysis

Xiao-fei Zhang et al.

Summary: This meta-analysis suggests that SBRT plus TACE is superior to monotherapy in treating HCC with PVTT, as it improves survival rates and treatment response without significant increase in adverse events.

PLOS ONE (2022)

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Review Oncology

Is liquid biopsy the future commutator of decision-making in liver transplantation for hepatocellular carcinoma?

Stephanie Gonvers et al.

Summary: Liquid biopsy has shown great potential in improving selection criteria for liver transplant in hepatocellular carcinoma. Despite limited studies, existing research highlights the significant prognostic value of liquid biopsy in this specific clinical scenario, emphasizing the urgent need for further research and integration into decision-making.

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Hepatocellular carcinoma

Arndt Vogel et al.

Summary: Hepatocellular carcinoma is a common cancer worldwide, with non-alcoholic fatty liver disease becoming a dominant cause. Treatment options are varied, including surgery, radiation, and medication. With the approval of new drugs and the development of immunotherapy, the outlook for hepatocellular carcinoma patients has improved, but the optimal sequencing of drugs and predictive biomarkers still need further research.

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Clinical analysis of deceased donor liver transplantation in the treatment of hepatocellular carcinoma with segmental portal vein tumor thrombus: A long-term real-world study

Meng Sha et al.

Summary: This study aimed to evaluate the feasibility and effectiveness of deceased donor liver transplantation (DDLT) in the treatment of hepatocellular carcinoma (HCC) with segmental portal vein tumor thrombus (PVTT). The study found significant differences in recurrence-free survival (RFS) and overall survival (OS) among HCC patients with different PVTT types during follow-up. For patients with segmental PVTT, DDLT may be a viable treatment option when the AFP level is <=100 ng/ml.

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HEPATOLOGY (2021)

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Effectiveness of stereotactic body radiotherapy for portal vein tumor thrombosis in patients with hepatocellular carcinoma and underlying chronic liver disease

Hoon Sik Choi et al.

Summary: SBRT, especially in combination with TACE, is an effective treatment for patients with HCC and PVTT. An optimal dose schedule must be followed to reduce hepatic toxicity while maintaining tumor response.

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Updated treatment recommendations for hepatocellular carcinoma (HCC) from the ESMO Clinical Practice Guidelines

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Summary: A systematic review of literature from 1993-2021 identified 59 different inclusion criteria for HCC patients undergoing liver transplantation, with new selection systems increasing transplantability by 31% without compromising patient outcomes. The development of an accepted comprehensive HCC-LT Score should be a priority to offer more patients a fair chance of justified transplantation. Further research is needed to establish internationally accepted expanded selection criteria for HCC patients seeking liver transplantation.

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Transarterial chemoembolization plus lenvatinib versus transarterial chemoembolization plus sorafenib as first-line treatment for hepatocellular carcinoma with portal vein tumor thrombus: A prospective randomized study

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CANCER (2021)

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Article Gastroenterology & Hepatology

Deceased Donor Liver Transplantation After Radioembolization for Hepatocellular Carcinoma and Portal Vein Tumoral Thrombosis: A Pilot Study

Matteo Serenari et al.

Summary: This study evaluated the effect of TARE in downstaging HCC patients with PVTT to meet criteria for DDLT. 5 out of 17 patients were able to undergo DDLT after TARE and showed significantly higher 5-year overall survival compared to those who were not transplanted. Careful selection for DDLT is advised despite the clear survival gain in patients who received DDLT after TARE.

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Review Oncology

Portal Vein Tumor Thrombosis and Hepatocellular Carcinoma - The Changing Tides

Abdul Rehman Khan et al.

Summary: Portal vein involvement is a feared complication of HCC, with treatment options including a combination of drugs and other modalities depending on the individual patient. While there are various therapeutic options available, the quest for the ideal combination therapy and sequence remains unanswered.

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Article Gastroenterology & Hepatology

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GUT (2020)

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Jens Ricke et al.

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Eduardo De Souza Martins Fernandes et al.

TRANSLATIONAL GASTROENTEROLOGY AND HEPATOLOGY (2019)

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Article Gastroenterology & Hepatology

AASLD guidelines for the treatment of hepatocellular carcinoma

Julie K. Heimbach et al.

HEPATOLOGY (2018)

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Article Radiology, Nuclear Medicine & Medical Imaging

90Y Radioembolization for Locally Advanced Hepatocellular Carcinoma with Portal Vein Thrombosis: Long-Term Outcomes in a 185-Patient Cohort

Nadine Abouchaleh et al.

JOURNAL OF NUCLEAR MEDICINE (2018)

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Management of Hepatocellular Carcinoma in Japan as a World-Leading Model

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LIVER CANCER (2018)

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Article Gastroenterology & Hepatology

Development of a prognostic score to predict response to Yttrium-90 radioembolization for hepatocellular carcinoma with portal vein invasion

Carlo Spreafico et al.

JOURNAL OF HEPATOLOGY (2018)

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Article Gastroenterology & Hepatology

EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma

Peter R. Galle et al.

JOURNAL OF HEPATOLOGY (2018)

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Article Medicine, General & Internal

Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial

Masatoshi Kudo et al.

LANCET (2018)

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Article Gastroenterology & Hepatology

Pilot study of living donor liver transplantation for patients with hepatocellular carcinoma exceeding Milan Criteria (Barcelona Clinic Liver Cancer extended criteria)

Josep M. Llovet et al.

LIVER TRANSPLANTATION (2018)

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Article Gastroenterology & Hepatology

Liver Transplantation After Transarterial Chemoembolization and Radiotherapy for Hepatocellular Carcinoma with Vascular Invasion

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JOURNAL OF GASTROINTESTINAL SURGERY (2017)

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Article Gastroenterology & Hepatology

Macrovascular Invasion Is Not an Absolute Contraindication for Living Donor Liver Transplantation

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Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial

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Article Gastroenterology & Hepatology

The Clinical Outcomes of Patients with Portal Vein Tumor Thrombi After Living Donor Liver Transplantation

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Survival outcomes of hepatic resection compared with transarterial chemoembolization or sorafenib for hepatocellular carcinoma with portal vein tumor thrombosis

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Article Gastroenterology & Hepatology

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Effectiveness of Stereotactic Body Radiotherapy for Hepatocellular Carcinoma with Portal Vein and/or Inferior Vena Cava Tumor Thrombosis

Mian Xi et al.

PLOS ONE (2013)

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WORLD JOURNAL OF GASTROENTEROLOGY (2013)

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Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report

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Barcelona Clinic Liver Cancer staging and transplant survival benefit for patients with hepatocellular carcinoma: a multicentre, cohort study

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