Number of Local Regional Therapies for Hepatocellular Carcinoma and Peri-Operative Outcomes after Liver Transplantation
The wait times for patients with hepatocellular carcinoma (HCC) listed for liver transplant are longer than ever, which has led to an increased reliance on the use of pre-operative LRTs. The impact that multiple rounds of LRTs have on peri-operative outcomes following transplant is unknown. This was...
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Veröffentlicht in: | Cancers 2023-01, Vol.15 (3), p.620 |
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description | The wait times for patients with hepatocellular carcinoma (HCC) listed for liver transplant are longer than ever, which has led to an increased reliance on the use of pre-operative LRTs. The impact that multiple rounds of LRTs have on peri-operative outcomes following transplant is unknown. This was a retrospective single center analysis of 298 consecutive patients with HCC who underwent liver transplant (January 2017 to May 2021). The data was obtained from two institution-specific databases and the TransQIP database. Of the 298 patients, 27 (9.1%) underwent no LRTs, 156 (52.4%) underwent 1-2 LRTs, and 115 (38.6%) underwent ≥3 LRTs prior to LT. The patients with ≥3 LRTs had a significantly higher rate of bile leak compared to patients who received 1-2 LRTs (7.0 vs. 1.3%,
= 0.014). Unadjusted and adjusted regression analyses demonstrated a significant association between the total number of LRTs administered and bile leak, but not rates of overall biliary complications. The total number of LRTs was not significantly associated with any other peri-operative or post-operative outcome measure. These findings support the aggressive use of LRTs to control HCC in patients awaiting liver transplant, with further evaluation needed to confirm the biliary leak findings. |
doi_str_mv | 10.3390/cancers15030620 |
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= 0.014). Unadjusted and adjusted regression analyses demonstrated a significant association between the total number of LRTs administered and bile leak, but not rates of overall biliary complications. The total number of LRTs was not significantly associated with any other peri-operative or post-operative outcome measure. These findings support the aggressive use of LRTs to control HCC in patients awaiting liver transplant, with further evaluation needed to confirm the biliary leak findings.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers15030620</identifier><identifier>PMID: 36765576</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Ablation ; Bile ; Care and treatment ; Hepatocellular carcinoma ; Hepatoma ; Ischemia ; Liver ; Liver cancer ; Liver transplantation ; Liver transplants ; Methods ; Patient outcomes ; Patients ; Preoperative care ; Regression analysis ; Thrombosis ; Transplantation</subject><ispartof>Cancers, 2023-01, Vol.15 (3), p.620</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c442t-d2fb84b8f072dac800334a88cba4b04b97e334713f281cf814855e9209b1a8473</cites><orcidid>0000-0002-6898-2114</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913666/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913666/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36765576$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brown, Audrey E</creatorcontrib><creatorcontrib>Shui, Amy M</creatorcontrib><creatorcontrib>Adelmann, Dieter</creatorcontrib><creatorcontrib>Mehta, Neil</creatorcontrib><creatorcontrib>Roll, Garrett R</creatorcontrib><creatorcontrib>Hirose, Ryutaro</creatorcontrib><creatorcontrib>Syed, Shareef M</creatorcontrib><title>Number of Local Regional Therapies for Hepatocellular Carcinoma and Peri-Operative Outcomes after Liver Transplantation</title><title>Cancers</title><addtitle>Cancers (Basel)</addtitle><description>The wait times for patients with hepatocellular carcinoma (HCC) listed for liver transplant are longer than ever, which has led to an increased reliance on the use of pre-operative LRTs. The impact that multiple rounds of LRTs have on peri-operative outcomes following transplant is unknown. This was a retrospective single center analysis of 298 consecutive patients with HCC who underwent liver transplant (January 2017 to May 2021). The data was obtained from two institution-specific databases and the TransQIP database. Of the 298 patients, 27 (9.1%) underwent no LRTs, 156 (52.4%) underwent 1-2 LRTs, and 115 (38.6%) underwent ≥3 LRTs prior to LT. The patients with ≥3 LRTs had a significantly higher rate of bile leak compared to patients who received 1-2 LRTs (7.0 vs. 1.3%,
= 0.014). Unadjusted and adjusted regression analyses demonstrated a significant association between the total number of LRTs administered and bile leak, but not rates of overall biliary complications. The total number of LRTs was not significantly associated with any other peri-operative or post-operative outcome measure. These findings support the aggressive use of LRTs to control HCC in patients awaiting liver transplant, with further evaluation needed to confirm the biliary leak findings.</description><subject>Ablation</subject><subject>Bile</subject><subject>Care and treatment</subject><subject>Hepatocellular carcinoma</subject><subject>Hepatoma</subject><subject>Ischemia</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver transplantation</subject><subject>Liver transplants</subject><subject>Methods</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Preoperative care</subject><subject>Regression analysis</subject><subject>Thrombosis</subject><subject>Transplantation</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptksFrFTEQxoMotjx79iYBL162TTbZJHsRykNb4eETeZ7DbDZ5TdlN1mS34n_fPFtrW0wOGSa_7xtmGITeUnLKWEvODARjU6YNYUTU5AU6romsKyFa_vJRfIROcr4m5TBGpZCv0RETUjSNFMfo19dl7GzC0eFNNDDg73bvYyjB7sommLzN2MWEL-0EczR2GJYBEl5DMj7EETCEHn-zyVfbqfCzv7F4u8wmjkUIbi7Wm5JLeJcg5GmAMBcohjfolYMh25P7d4V-fP60W19Wm-3Fl_X5pjKc13PV165TvFOuNNODUYceOChlOuAd4V0rbUlIylytqHGKctU0tq1J21FQXLIV-njnOy3daHtjw5xg0FPyI6TfOoLXT3-Cv9L7eKPbljIhRDH4cG-Q4s_F5lmPPh_mAMHGJetaykbUjap5Qd8_Q6_jksos_1BcqYZS9o_aw2C1Dy6WuuZgqs8lZ4S0smArdPofqtzejt7EYJ0v-SeCszuBSTHnZN1Dj5Tow7roZ-tSFO8ej-aB_7sc7BbCTbxZ</recordid><startdate>20230119</startdate><enddate>20230119</enddate><creator>Brown, Audrey E</creator><creator>Shui, Amy M</creator><creator>Adelmann, Dieter</creator><creator>Mehta, Neil</creator><creator>Roll, Garrett R</creator><creator>Hirose, Ryutaro</creator><creator>Syed, Shareef M</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6898-2114</orcidid></search><sort><creationdate>20230119</creationdate><title>Number of Local Regional Therapies for Hepatocellular Carcinoma and Peri-Operative Outcomes after Liver Transplantation</title><author>Brown, Audrey E ; Shui, Amy M ; Adelmann, Dieter ; Mehta, Neil ; Roll, Garrett R ; Hirose, Ryutaro ; Syed, Shareef M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-d2fb84b8f072dac800334a88cba4b04b97e334713f281cf814855e9209b1a8473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Ablation</topic><topic>Bile</topic><topic>Care and treatment</topic><topic>Hepatocellular carcinoma</topic><topic>Hepatoma</topic><topic>Ischemia</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Liver transplantation</topic><topic>Liver transplants</topic><topic>Methods</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Preoperative care</topic><topic>Regression analysis</topic><topic>Thrombosis</topic><topic>Transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brown, Audrey E</creatorcontrib><creatorcontrib>Shui, Amy M</creatorcontrib><creatorcontrib>Adelmann, Dieter</creatorcontrib><creatorcontrib>Mehta, Neil</creatorcontrib><creatorcontrib>Roll, Garrett R</creatorcontrib><creatorcontrib>Hirose, Ryutaro</creatorcontrib><creatorcontrib>Syed, Shareef M</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brown, Audrey E</au><au>Shui, Amy M</au><au>Adelmann, Dieter</au><au>Mehta, Neil</au><au>Roll, Garrett R</au><au>Hirose, Ryutaro</au><au>Syed, Shareef M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Number of Local Regional Therapies for Hepatocellular Carcinoma and Peri-Operative Outcomes after Liver Transplantation</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2023-01-19</date><risdate>2023</risdate><volume>15</volume><issue>3</issue><spage>620</spage><pages>620-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>The wait times for patients with hepatocellular carcinoma (HCC) listed for liver transplant are longer than ever, which has led to an increased reliance on the use of pre-operative LRTs. 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= 0.014). Unadjusted and adjusted regression analyses demonstrated a significant association between the total number of LRTs administered and bile leak, but not rates of overall biliary complications. The total number of LRTs was not significantly associated with any other peri-operative or post-operative outcome measure. These findings support the aggressive use of LRTs to control HCC in patients awaiting liver transplant, with further evaluation needed to confirm the biliary leak findings.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>36765576</pmid><doi>10.3390/cancers15030620</doi><orcidid>https://orcid.org/0000-0002-6898-2114</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Ablation Bile Care and treatment Hepatocellular carcinoma Hepatoma Ischemia Liver Liver cancer Liver transplantation Liver transplants Methods Patient outcomes Patients Preoperative care Regression analysis Thrombosis Transplantation |
title | Number of Local Regional Therapies for Hepatocellular Carcinoma and Peri-Operative Outcomes after Liver Transplantation |
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