Frager SZ, Cooper W, Saenger Y, Schwartz JM. Treatment of recurrent hepatocellular carcinoma following liver resection, ablation or liver transplantation. World J Meta-Anal 2023; 11(2): 47-54 [DOI: 10.13105/wjma.v11.i2.47]
Corresponding Author of This Article
Shalom Z Frager, MD, Staff Physician, Department of Hepatology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467, United States. shfrager@montefiore.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Meta-Anal. Feb 3, 2023; 11(2): 47-54 Published online Feb 3, 2023. doi: 10.13105/wjma.v11.i2.47
Treatment of recurrent hepatocellular carcinoma following liver resection, ablation or liver transplantation
Shalom Z Frager, Weston Cooper, Yvonne Saenger, Jonathan M Schwartz
Shalom Z Frager, Department of Medicine, Division of Hepatology, Montefiore Medical Center, Bronx, NY 10467, United States
Weston Cooper, Yvonne Saenger, Cancer Center, Montefiore Medical Center, Bronx, NY 10467, United States
Jonathan M Schwartz, Department of Medicine, Division Hepatology, Montefiore Medical Center, Bronx, NY 10467, United States
Author contributions: Frager SZ wrote a majority of the manuscript; Frager SZ edited the entire manuscript; Cooper W and Saenger Y contributed to the immunotherapy section; Schwartz JM contributed to the liver transplantation sub-section and provided manuscript editing.
Conflict-of-interest statement: All the authors have no conflict of interests to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shalom Z Frager, MD, Staff Physician, Department of Hepatology, Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467, United States. shfrager@montefiore.org
Received: October 20, 2022 Peer-review started: October 20, 2022 First decision: November 14, 2022 Revised: November 30, 2022 Accepted: January 17, 2023 Article in press: January 17, 2023 Published online: February 3, 2023
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and causes one third of cancer related deaths world-wide. Approximately one third of patients with HCC are eligible for curative treatments that include hepatic resection, liver transplantation or imaging guided tumor ablation. Recurrence rates after primary therapy depends on tumor biology and pre-treatment tumor burden with early recurrence rates ranging from 30%-80% following surgical resection and ablation. HCC recurs in over ten percent following liver transplantation for HCC. Treatment modalities for tumor recurrence following resection and ablation include repeat liver resection, salvage liver transplantation, locoregional therapies, and systemic chemotherapy/immunotherapy. Locoregional and immune mediated therapies are limited for patients with tumor recurrence following liver transplantation given potential immune related allograft rejection. Given the high HCC recurrence rates after primary tumor treatment, it is imperative for the clinician to review the appropriate treatment strategy for this disease entity. This article will review the current literature regarding HCC recurrence after primary curative therapies and will discuss the relevant future trends in the HCC field.
Core Tip: Tumor recurrence is frequent following potentially curative modalities for hepatocellular carcinoma. Patients should undergo surveillance imaging following curative treatments and once diagnosed, are potentially eligible for repeat hepatic resection, ablation, trans-arterial embolic therapies, or systemic therapies.
