Cargando…

A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity

Hepatocellular carcinoma (HCC) recurrence after liver transplant is associated with a poor prognosis and significantly increases morbidity and mortality among liver transplant patients. Therefore, this meta-analysis aims to evaluate the overall prevalence of HCC recurrence following liver transplant...

Descripción completa

Detalles Bibliográficos
Autores principales: Tan, Darren J. H., Wong, Chloe, Ng, Cheng Han, Poh, Chen Wei, Jain, Sneha Rajiv, Huang, Daniel Q., Muthiah, Mark D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828059/
https://www.ncbi.nlm.nih.gov/pubmed/33440759
http://dx.doi.org/10.3390/jcm10020238
_version_ 1783640917108850688
author Tan, Darren J. H.
Wong, Chloe
Ng, Cheng Han
Poh, Chen Wei
Jain, Sneha Rajiv
Huang, Daniel Q.
Muthiah, Mark D.
author_facet Tan, Darren J. H.
Wong, Chloe
Ng, Cheng Han
Poh, Chen Wei
Jain, Sneha Rajiv
Huang, Daniel Q.
Muthiah, Mark D.
author_sort Tan, Darren J. H.
collection PubMed
description Hepatocellular carcinoma (HCC) recurrence after liver transplant is associated with a poor prognosis and significantly increases morbidity and mortality among liver transplant patients. Therefore, this meta-analysis aims to evaluate the overall prevalence of HCC recurrence following liver transplant. Medline and Embase databases were searched, and a meta-analysis of proportions was conducted. Observational studies reporting the prevalence of recurrent hepatocellular carcinoma (HCC) after liver transplant were included, with the analysis being stratified by adherence to Milan criteria, ethnicity, socio-economic status, alpha fetoprotein (AFP) levels, living donor vs. deceased donor, and the underlying aetiology of the liver disease. A meta-regression on the date of the study completion was also performed. Of a total 40,495 patients, 3888 developed an HCC recurrence. The overall prevalence of recurrent HCC was 13% (CI: 0.12–0.15). Patients beyond the Milan criteria (MC) were more likely to recur than patients within MC. Asian populations had the greatest prevalence of HCC recurrence (19%; CI: 0.15–0.24) when compared to Western (12%; CI: 0.11–0.13) and Latin American populations (11%; CI: 0.09–0.14). The prevalence of recurrent HCC was the highest in patients infected with hepatitis B virus (HBV) (18%; CI: 0.11–0.27) compared to other aetiologies. A higher AFP also resulted in an increased recurrence. This highlights interesting differences based on ethnicity, income, and aetiology, and further studies are needed to determine the reasons for the disparity.
format Online
Article
Text
id pubmed-7828059
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-78280592021-01-25 A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity Tan, Darren J. H. Wong, Chloe Ng, Cheng Han Poh, Chen Wei Jain, Sneha Rajiv Huang, Daniel Q. Muthiah, Mark D. J Clin Med Review Hepatocellular carcinoma (HCC) recurrence after liver transplant is associated with a poor prognosis and significantly increases morbidity and mortality among liver transplant patients. Therefore, this meta-analysis aims to evaluate the overall prevalence of HCC recurrence following liver transplant. Medline and Embase databases were searched, and a meta-analysis of proportions was conducted. Observational studies reporting the prevalence of recurrent hepatocellular carcinoma (HCC) after liver transplant were included, with the analysis being stratified by adherence to Milan criteria, ethnicity, socio-economic status, alpha fetoprotein (AFP) levels, living donor vs. deceased donor, and the underlying aetiology of the liver disease. A meta-regression on the date of the study completion was also performed. Of a total 40,495 patients, 3888 developed an HCC recurrence. The overall prevalence of recurrent HCC was 13% (CI: 0.12–0.15). Patients beyond the Milan criteria (MC) were more likely to recur than patients within MC. Asian populations had the greatest prevalence of HCC recurrence (19%; CI: 0.15–0.24) when compared to Western (12%; CI: 0.11–0.13) and Latin American populations (11%; CI: 0.09–0.14). The prevalence of recurrent HCC was the highest in patients infected with hepatitis B virus (HBV) (18%; CI: 0.11–0.27) compared to other aetiologies. A higher AFP also resulted in an increased recurrence. This highlights interesting differences based on ethnicity, income, and aetiology, and further studies are needed to determine the reasons for the disparity. MDPI 2021-01-11 /pmc/articles/PMC7828059/ /pubmed/33440759 http://dx.doi.org/10.3390/jcm10020238 Text en © 2021 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 (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Tan, Darren J. H.
Wong, Chloe
Ng, Cheng Han
Poh, Chen Wei
Jain, Sneha Rajiv
Huang, Daniel Q.
Muthiah, Mark D.
A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity
title A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity
title_full A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity
title_fullStr A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity
title_full_unstemmed A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity
title_short A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity
title_sort meta-analysis on the rate of hepatocellular carcinoma recurrence after liver transplant and associations to etiology, alpha-fetoprotein, income and ethnicity
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828059/
https://www.ncbi.nlm.nih.gov/pubmed/33440759
http://dx.doi.org/10.3390/jcm10020238
work_keys_str_mv AT tandarrenjh ametaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT wongchloe ametaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT ngchenghan ametaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT pohchenwei ametaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT jainsneharajiv ametaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT huangdanielq ametaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT muthiahmarkd ametaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT tandarrenjh metaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT wongchloe metaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT ngchenghan metaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT pohchenwei metaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT jainsneharajiv metaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT huangdanielq metaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity
AT muthiahmarkd metaanalysisontherateofhepatocellularcarcinomarecurrenceafterlivertransplantandassociationstoetiologyalphafetoproteinincomeandethnicity