Document Detail


Pre-liver transplant biopsy in hepatocellular carcinoma: a potential criterion for exclusion from transplantation?
MedLine Citation:
PMID:  23458127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In cirrhotic patients with hepatocellular carcinoma (HCC), poor differentiation in pre-liver transplantation (LT) biopsy of the largest tumour is used as a criterion for exclusion from LT in some centres. The potential role of pre-LT biopsy at one centre was explored.
METHODS: A prospective database of patients undergoing orthotopic LT for radiologically diagnosed HCC at St James's University Hospital, Leeds during 2006-2011 was analysed.
RESULTS: A total of 60 predominantly male (85.0%) patients with viral hepatitis were identified. There were discrepancies between radiological and histopathological findings with respect to the number of tumours identified (in 27 patients, 45.0%) and their size (in 63 tumours, 64.3%). In four (6.7%) patients, the largest lesion, which would theoretically have been targeted for biopsy, was not the largest in the explant. Nine (31.0%) patients with multifocal HCC had tumours of differing grades. In two (6.9%) patients, the largest tumour was well differentiated, but smaller tumours in the explant were poorly differentiated. In one patient, the largest lesion was benign and smaller invasive tumours were confirmed histologically.
CONCLUSIONS: The need to optimize selection for LT in HCC remains. In the present series, the largest tumour was not always representative of overall tumour burden or biological aggression and its potential use to exclude patients from LT is questionable.
Authors:
Richard S Young; Mohammed Aldiwani; Abdul R Hakeem; Amit Nair; Ashley Guthrie; Judy Wyatt; Darren Treanor; Gareth Morris-Stiff; Rebecca L Jones; K Rajendra Prasad
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Publication Detail:
Type:  Journal Article     Date:  2012-12-27
Journal Detail:
Title:  HPB : the official journal of the International Hepato Pancreato Biliary Association     Volume:  15     ISSN:  1477-2574     ISO Abbreviation:  HPB (Oxford)     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-10     Completed Date:  2013-12-16     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  100900921     Medline TA:  HPB (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  418-27     Citation Subset:  IM    
Copyright Information:
© 2012 International Hepato-Pancreato-Biliary Association.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biopsy*
Carcinoma, Hepatocellular / mortality,  pathology*,  radiography,  surgery*
Cell Differentiation
Decision Support Techniques*
England
Female
Humans
Kaplan-Meier Estimate
Liver Neoplasms / mortality,  pathology*,  radiography,  surgery*
Liver Transplantation* / adverse effects,  mortality
Male
Middle Aged
Multivariate Analysis
Neoplasm Grading
Neoplasm Invasiveness
Neoplasms, Multiple Primary / mortality,  pathology*,  radiography,  surgery*
Patient Selection*
Predictive Value of Tests
Preoperative Care
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Tertiary Care Centers
Tumor Burden
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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