title: Recurrence of hepatocellular carcinoma after liver transplantation: an update.
abstract: Liver transplantation is the only curative alternative for selected patients with hepatocellular carcinoma (HCC) who are not eligible for resection and/or with decompensated cirrhosis. According to Milan criteria the 5-year survival rate is 70-85%, with a recurrence-free survival of 75%. However, HCC recurrence rate after liver transplantation remains a significant problem in the clinical practice. The prognosis in patients with HCC recurrence is poor. The treatment of choice for HCC recurrence is surgery, but it seems that a systemic treatment based on combination of an mTOR inhibitor with sorafenib can be used. Data on safety and efficacy are limited, clinical monitoring is necessary. The aim of this review is to underline the main concerns, pitfalls and warnings for these patients.
authors.affiliation: Section of Gastroenterology - Di.Bi.M.I.S., University of Palermo, Palermo, Italy.|Unité Médicale de Transplantation Hépatique AP-HP, Hôpital Pitié-Salpêtrière, UPMC Paris, Paris, France.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mazzola
authors.affiliation: Section of Gastroenterology - Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Costantino
authors.affiliation: Section of Gastroenterology - Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Petta
authors.affiliation: Section of Radiology - Di.Bi.Me.F., University of Palermo, Palermo, Italy.
authors.forename: Tommaso Vincenzo
authors.initials: TV
authors.lastname: Bartolotta
authors.affiliation: Section of Anesthesiology, Analgesia, Intensive Care & Emergency, Department of Biopathology, Medical & Forensic Biotechnologies (DIBIMEF), Policlinico 'P Giaccone', University of Palermo, Palermo, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Raineri
authors.affiliation: Gastroenterology Unit, Cisanello Hospital, Pisa, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Sacco
authors.affiliation: Section of Radiology - Di.Bi.Me.F., University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Brancatelli
authors.affiliation: Section of Gastroenterology - Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
authors.forename: Calogero
authors.initials: C
authors.lastname: Cammà
authors.affiliation: Section of Gastroenterology - Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cabibbo
mesh_terms: D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods; D009364:Neoplasm Recurrence, Local; D059035:Perioperative Period; D012307:Risk Factors; D047368:Tumor Burden; D000509:alpha-Fetoproteins / Q000235:genetics / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins
keywords: hepatocellular carcinoma; immunosuppression; liver transplantation; living donors; recurrence