PMID- 22994652
OWN - NLM
STAT- MEDLINE
DCOM- 20130627
LR  - 20220419
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Linking)
VI  - 26
IP  - 2
DP  - 2013 Feb
TI  - Recurrent hepatocellular carcinoma after liver transplantation - an emerging 
      clinical challenge.
PG  - 109-18
LID - 10.1111/j.1432-2277.2012.01562.x [doi]
AB  - In western countries, hepatocellular carcinoma (HCC) is a major reason for 
      orthotopic liver transplantation (OLT) with estimated recurrence rates between 
      15% and 20%. This selective literature review addresses follow-up care after OLT 
      in HCC and current treatment options. Recurrence prediction is based on 
      pathological tumor stage, vascular invasion, serum alfafetoprotein levels, and 
      histological differentiation, but further advances are expected by molecular 
      profiling techniques. Lower levels of immunosuppressive agents are associated 
      with a lower risk for HCC recurrence. Retrospective studies indicate that 
      mammalian target of rapamycin (mTOR) inhibitors as immunosuppression reduce the 
      risk of HCC recurrence. However, prospective studies supporting this potential 
      advantage of mTOR inhibitors are still lacking, and higher rejection rates were 
      reported for sirolimus after OLT in HCC. Prognosis is poor in recurrent HCC, a 
      longer interval between OLT and recurrence and feasibility of surgical resection 
      are associated with improved survival. Systemic treatment with sorafenib is the 
      current standard of care in patients with advanced-stage HCC not suitable for 
      locoregional therapy. After OLT, combination of an mTOR inhibitor with sorafenib 
      is feasible and frequently used in clinical practice. As safety and efficacy data 
      are still limited, close clinical monitoring is mandatory.
CI  - (c) 2012 The Authors Transplant International (c) 2012 European Society for Organ 
      Transplantation. Published by Blackwell Publishing Ltd.
FAU - Welker, Martin-Walter
AU  - Welker MW
AD  - Medizinische Klinik 1, Klinikum der Johann-Wolfgang Goethe-Universitat, Frankfurt 
      am Main, Germany.  
FAU - Bechstein, Wolf-Otto
AU  - Bechstein WO
FAU - Zeuzem, Stefan
AU  - Zeuzem S
FAU - Trojan, Joerg
AU  - Trojan J
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20120921
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Phenylurea Compounds)
RN  - 25X51I8RD4 (Niacinamide)
RN  - 9ZOQ3TZI87 (Sorafenib)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Animals
MH  - Carcinoma, Hepatocellular/*diagnosis
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Liver Neoplasms/*diagnosis/*therapy
MH  - Liver Transplantation/*pathology
MH  - *Neoplasm Recurrence, Local
MH  - Niacinamide/analogs & derivatives/therapeutic use
MH  - Phenylurea Compounds/therapeutic use
MH  - Risk Factors
MH  - Sorafenib
MH  - TOR Serine-Threonine Kinases/metabolism
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2012/09/22 06:00
MHDA- 2013/06/29 06:00
CRDT- 2012/09/22 06:00
PHST- 2012/09/22 06:00 [entrez]
PHST- 2012/09/22 06:00 [pubmed]
PHST- 2013/06/29 06:00 [medline]
AID - 10.1111/j.1432-2277.2012.01562.x [doi]
PST - ppublish
SO  - Transpl Int. 2013 Feb;26(2):109-18. doi: 10.1111/j.1432-2277.2012.01562.x. Epub 
      2012 Sep 21.