PMID- 32426094
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 1948-9366 (Print)
IS  - 1948-9366 (Electronic)
VI  - 12
IP  - 4
DP  - 2020 Apr 27
TI  - Mammalian target of rapamycin inhibitors after post-transplant hepatocellular 
      carcinoma recurrence: Is it too late?
PG  - 149-158
LID - 10.4240/wjgs.v12.i4.149 [doi]
AB  - BACKGROUND: Mammalian target of rapamycin (mTOR) inhibitors have been shown to 
      reduce the risk of tumour recurrence after liver transplantation for 
      hepatocellular carcinoma (HCC). However, their role in established 
      post-transplant HCC recurrence is uncertain. AIM: To investigate whether mTOR 
      inhibitor offers a survival benefit in post-transplant HCC recurrence. METHODS: A 
      retrospective study of 143 patients who developed HCC recurrence after liver 
      transplantation was performed. They were divided into 2 groups based on whether 
      they had received mTOR inhibitor-based immunosuppression. The primary endpoint 
      was post-recurrence survival. RESULTS: Seventy-nine (55%) patients received an 
      mTOR inhibitor-based immunosuppressive regime, while 64 (45%) patients did not. 
      The mTOR inhibitor group had a lower number of recurrent tumours (2 vs 5, P = 
      0.02) and received more active treatments including radiotherapy (39 vs 22%, P = 
      0.03) and targeted therapy (59 vs 23%, P < 0.001). The median post-recurrence 
      survival was 21.0 +/- 4.1 mo in the mTOR inhibitor group and 11.2 +/- 2.5 mo in the 
      control group. Multivariate Cox regression analysis confirmed that mTOR inhibitor 
      therapy was independently associated with improved post-recurrence survival (P = 
      0.04, OR = 0.482, 95%CI: 0.241-0.966). The number of recurrent tumours and use of 
      other treatment modalities did not affect survival. No survival difference was 
      observed between mTOR inhibitor monotherapy and combination therapy with 
      calcineurin inhibitor. CONCLUSION: mTOR inhibitors prolonged survival after 
      post-transplant HCC recurrence.
CI  - (c)The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights 
      reserved.
FAU - Au, Kin Pan
AU  - Au KP
AD  - Department of Surgery, Queen Mary Hospital, Hong Kong 999077, China.
FAU - Chok, Kenneth Siu Ho
AU  - Chok KSH
AD  - Department of Surgery and State Key Laboratory for Liver Research, The University 
      of Hong Kong, Hong Kong 999077, China. chok6275@hku.hk.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Gastrointest Surg
JT  - World journal of gastrointestinal surgery
JID - 101532473
PMC - PMC7215969
OTO - NOTNLM
OT  - Hepatocellular carcinoma
OT  - Liver transplant
OT  - Mammalian target of rapamycin inhibitor
OT  - Outcomes
OT  - Recurrence
OT  - Survival
COIS- Conflict-of-interest statement: None of the authors has any conflict of interest.
EDAT- 2020/05/20 06:00
MHDA- 2020/05/20 06:01
PMCR- 2020/04/27
CRDT- 2020/05/20 06:00
PHST- 2019/12/30 00:00 [received]
PHST- 2020/03/21 00:00 [revised]
PHST- 2020/03/26 00:00 [accepted]
PHST- 2020/05/20 06:00 [entrez]
PHST- 2020/05/20 06:00 [pubmed]
PHST- 2020/05/20 06:01 [medline]
PHST- 2020/04/27 00:00 [pmc-release]
AID - 10.4240/wjgs.v12.i4.149 [doi]
PST - ppublish
SO  - World J Gastrointest Surg. 2020 Apr 27;12(4):149-158. doi: 
      10.4240/wjgs.v12.i4.149.