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International study on the outcome of locoregional therapy for liver transplant in hepatocellular carcinoma beyond Milan criteria / Sergio Iván Hoyos Duque
Título : International study on the outcome of locoregional therapy for liver transplant in hepatocellular carcinoma beyond Milan criteria Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Autor asociado al HPTU Fecha de publicación : 2021 Títulos uniformes : JHEP Reports Idioma : Inglés (eng) Palabras clave : Hepatocellular carcinoma Downstaging UCSF downstaging protocol All-comers Alpha-foetoprotein Resumen : Background & Aims: Good outcomes after liver transplantation (LT) have been reported after successfully downstaging to Milan criteria in more advanced hepatocellular carcinoma (HCC). We aimed to compare post-LT outcomes in patients receiving locoregional therapies (LRT) before LT according to Milan criteria and University of California San Francisco downstaging (UCSF-DS) protocol and ‘all-comers’. Methods: This multicentre cohort study included patients who received any LRT before LT from Europe and Latin America (2000–2018). We excluded patients with alpha-foetoprotein (AFP) above 1,000 ng/ml. Competing risk regression analysis for HCC recurrence was conducted, estimating subdistribution hazard ratios (SHRs) and corresponding 95% CIs. Results: From 2,441 LT patients, 70.1% received LRT before LT (n = 1,711). Of these, 80.6% were within Milan, 12.0% within UCSF-DS, and 7.4% all-comers. Successful downstaging was achieved in 45.2% (CI 34.8–55.8) and 38.2% (CI 25.4–52.3) of the UCSF-DS group and all-comers, respectively. The risk of recurrence was higher for all-comers (SHR 6.01 [p <0.0001]) and not significantly higher for the UCSF-DS group (SHR 1.60 [p = 0.32]), compared with patients remaining within Milan. The all-comers presented more frequent features of aggressive HCC and higher tumour burden at explant. Among the UCSF-DS group, an AFP value of ≤20 ng/ml at listing was associated with lower recurrence (SHR 2.01 [p = 0.006]) and better survival. However, recurrence was still significantly high irrespective of AFP ≤20 ng/ml in all-comers. Conclusions: Patients within the UCSF-DS protocol at listing have similar post-transplant outcomes compared with those within Milan when successfully downstaged. Meanwhile, all-comers have a higher recurrence and inferior survival irrespective of response to LRT. Additionally, in the UCSF-DS group, an ALP of ≤20 ng/ml might be a novel tool to optimise selection of candidates for LT. Mención de responsabilidad : Helena Degroote, Federico Piñero, Charlotte Costentin, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Aline Lopes Chagas, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrio Di Benedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Adrián Gadano, Claire Vanlemmens, Stefano Fagiuoli, Fernando Rubinstein, Patrizia Burra, Daniel Cherqui, Marcelo Silva, Hans Van Vlierberghe, Christophe Duvoux, for the French-Italian-Belgium and Latin American collaborative group for HCC and liver transplantation Referencia : JHEP Rep. 2021 Jul 13;3(5):100331. DOI (Digital Object Identifier) : 10.1016/j.jhepr.2021.100331 PMID : 34485882 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589555921001075 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis International study on the outcome of locoregional therapy for liver transplant in hepatocellular carcinoma beyond Milan criteria [documento electrónico] / Sergio Iván Hoyos Duque, Autor asociado al HPTU . - 2021.
Obra : JHEP Reports
Idioma : Inglés (eng)
Palabras clave : Hepatocellular carcinoma Downstaging UCSF downstaging protocol All-comers Alpha-foetoprotein Resumen : Background & Aims: Good outcomes after liver transplantation (LT) have been reported after successfully downstaging to Milan criteria in more advanced hepatocellular carcinoma (HCC). We aimed to compare post-LT outcomes in patients receiving locoregional therapies (LRT) before LT according to Milan criteria and University of California San Francisco downstaging (UCSF-DS) protocol and ‘all-comers’. Methods: This multicentre cohort study included patients who received any LRT before LT from Europe and Latin America (2000–2018). We excluded patients with alpha-foetoprotein (AFP) above 1,000 ng/ml. Competing risk regression analysis for HCC recurrence was conducted, estimating subdistribution hazard ratios (SHRs) and corresponding 95% CIs. Results: From 2,441 LT patients, 70.1% received LRT before LT (n = 1,711). Of these, 80.6% were within Milan, 12.0% within UCSF-DS, and 7.4% all-comers. Successful downstaging was achieved in 45.2% (CI 34.8–55.8) and 38.2% (CI 25.4–52.3) of the UCSF-DS group and all-comers, respectively. The risk of recurrence was higher for all-comers (SHR 6.01 [p <0.0001]) and not significantly higher for the UCSF-DS group (SHR 1.60 [p = 0.32]), compared with patients remaining within Milan. The all-comers presented more frequent features of aggressive HCC and higher tumour burden at explant. Among the UCSF-DS group, an AFP value of ≤20 ng/ml at listing was associated with lower recurrence (SHR 2.01 [p = 0.006]) and better survival. However, recurrence was still significantly high irrespective of AFP ≤20 ng/ml in all-comers. Conclusions: Patients within the UCSF-DS protocol at listing have similar post-transplant outcomes compared with those within Milan when successfully downstaged. Meanwhile, all-comers have a higher recurrence and inferior survival irrespective of response to LRT. Additionally, in the UCSF-DS group, an ALP of ≤20 ng/ml might be a novel tool to optimise selection of candidates for LT. Mención de responsabilidad : Helena Degroote, Federico Piñero, Charlotte Costentin, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Aline Lopes Chagas, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrio Di Benedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Adrián Gadano, Claire Vanlemmens, Stefano Fagiuoli, Fernando Rubinstein, Patrizia Burra, Daniel Cherqui, Marcelo Silva, Hans Van Vlierberghe, Christophe Duvoux, for the French-Italian-Belgium and Latin American collaborative group for HCC and liver transplantation Referencia : JHEP Rep. 2021 Jul 13;3(5):100331. DOI (Digital Object Identifier) : 10.1016/j.jhepr.2021.100331 PMID : 34485882 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2589555921001075 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001823 AC-2021-133 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2021-133Adobe Acrobat PDF Liver transplantation for hepatocellular carcinoma: impact of expansion criteria in a multicenter cohort study from a high waitlist mortality region / Sergio Iván Hoyos Duque
Título : Liver transplantation for hepatocellular carcinoma: impact of expansion criteria in a multicenter cohort study from a high waitlist mortality region Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Autor asociado al HPTU Fecha de publicación : 2021 Títulos uniformes : Transplant International Idioma : Inglés (eng) Palabras clave : allocation hepatocellular carcinoma liver transplantation selection Resumen : This study aimed to compare liver transplantation (LT) outcomes and evaluate the potential rise in numbers of LT candidates with hepatocellular carcinoma (HCC) of different allocation policies in a high waitlist mortality region. Three policies were applied in two Latin American cohorts (1085 HCC transplanted patients and 917 listed patients for HCC): (i) Milan criteria with expansion according to UCSF downstaging (UCSF-DS), (ii) the AFP score, and (iii) restrictive policy or Double Eligibility Criteria (DEC; within Milan + AFP score ≤2). Increase in HCC patient numbers was evaluated in an Argentinian prospective validation set (INCUCAI; NCT03775863). Expansion criteria in policy A showed that UCSF-DS [28.4% (CI 12.8–56.2)] or “all-comers” [32.9% (CI 11.9–71.3)] had higher 5-year recurrence rates compared to Milan, with 10.9% increase in HCC patients for LT. The policy B showed lower recurrence rates for AFP scores ≤2 points, even expanding beyond Milan criteria, with a 3.3% increase. Patients within DEC had lower 5-year recurrence rates compared with those beyond DEC [13.3% (CI 10.1–17.3) vs 24.2% (CI 17.4–33.1; P = 0.0006], without significant HCC expansion. In conclusion, although the application of a stricter policy may optimize the selection process, this restrictive policy may lead to ethical concerns in organ allocation (NCT03775863). Mención de responsabilidad : Federico Pinero, Margarita Anders, Ilka F. Boin, Aline Chagas, Emilio Quinonez, Sebastian Marciano, Mario Vilatoba, Luisa Santos, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaria Menendez, Martin Padilla, Jaime Poniachik, Rodrigo Zapata, Alejandro Soza, Martin Maraschio, Ricardo Chong Menendez, Linda Munoz, Diego Arufe, Rodrigo Figueroa, Elaine Cristina de Ataide, Claudia Maccali, Rodrigo Vergara Sandoval, Carla Bermudez, Luis G. Podesta, Lucas McCormack, Adriana Varon, Adrian Gadano, Juan Mattera, Federico Villamil, Fernando Rubinstein, Flair Carrilho & Marcelo Silva Referencia : Transpl Int. 2021 Jan;34(1):97-109. DOI (Digital Object Identifier) : 10.1111/tri.13767 PMID : 33040420 En línea : https://onlinelibrary.wiley.com/doi/10.1111/tri.13767 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Liver transplantation for hepatocellular carcinoma: impact of expansion criteria in a multicenter cohort study from a high waitlist mortality region [documento electrónico] / Sergio Iván Hoyos Duque, Autor asociado al HPTU . - 2021.
Obra : Transplant International
Idioma : Inglés (eng)
Palabras clave : allocation hepatocellular carcinoma liver transplantation selection Resumen : This study aimed to compare liver transplantation (LT) outcomes and evaluate the potential rise in numbers of LT candidates with hepatocellular carcinoma (HCC) of different allocation policies in a high waitlist mortality region. Three policies were applied in two Latin American cohorts (1085 HCC transplanted patients and 917 listed patients for HCC): (i) Milan criteria with expansion according to UCSF downstaging (UCSF-DS), (ii) the AFP score, and (iii) restrictive policy or Double Eligibility Criteria (DEC; within Milan + AFP score ≤2). Increase in HCC patient numbers was evaluated in an Argentinian prospective validation set (INCUCAI; NCT03775863). Expansion criteria in policy A showed that UCSF-DS [28.4% (CI 12.8–56.2)] or “all-comers” [32.9% (CI 11.9–71.3)] had higher 5-year recurrence rates compared to Milan, with 10.9% increase in HCC patients for LT. The policy B showed lower recurrence rates for AFP scores ≤2 points, even expanding beyond Milan criteria, with a 3.3% increase. Patients within DEC had lower 5-year recurrence rates compared with those beyond DEC [13.3% (CI 10.1–17.3) vs 24.2% (CI 17.4–33.1; P = 0.0006], without significant HCC expansion. In conclusion, although the application of a stricter policy may optimize the selection process, this restrictive policy may lead to ethical concerns in organ allocation (NCT03775863). Mención de responsabilidad : Federico Pinero, Margarita Anders, Ilka F. Boin, Aline Chagas, Emilio Quinonez, Sebastian Marciano, Mario Vilatoba, Luisa Santos, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaria Menendez, Martin Padilla, Jaime Poniachik, Rodrigo Zapata, Alejandro Soza, Martin Maraschio, Ricardo Chong Menendez, Linda Munoz, Diego Arufe, Rodrigo Figueroa, Elaine Cristina de Ataide, Claudia Maccali, Rodrigo Vergara Sandoval, Carla Bermudez, Luis G. Podesta, Lucas McCormack, Adriana Varon, Adrian Gadano, Juan Mattera, Federico Villamil, Fernando Rubinstein, Flair Carrilho & Marcelo Silva Referencia : Transpl Int. 2021 Jan;34(1):97-109. DOI (Digital Object Identifier) : 10.1111/tri.13767 PMID : 33040420 En línea : https://onlinelibrary.wiley.com/doi/10.1111/tri.13767 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001818 AC-2021-130 Archivo digital Producción Científica Artículos científicos Disponible Recurrence of hepatocellular carcinoma after liver transplantation: Prognostic and predictive factors of survival in a Latin American cohort / Sergio Iván Hoyos Duque
Título : Recurrence of hepatocellular carcinoma after liver transplantation: Prognostic and predictive factors of survival in a Latin American cohort Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Autor asociado al HPTU Fecha de publicación : 2021 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : hepatocellular carcinoma liver transplantation prognosis recurrence treatment Resumen : Background & aim: Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) has a poor prognosis, and the adjusted effect of different treatments on post-recurrence survival (PRS) has not been well defined. This study aims to evaluate prognostic and predictive variables associated with PRS. Methods: This Latin American multicenter retrospective cohort study included HCC patients who underwent LT between the years 2005-2018. We evaluated the effect of baseline characteristics at time of HCC recurrence diagnosis and PRS (Cox regression analysis). Early recurrences were those occurring within 12 months of LT. To evaluate the adjusted treatment effect for HCC recurrence, a propensity score matching analysis was performed to assess the probability of having received any specific treatment for recurrence. Results: From a total of 1085 transplanted HCC patients, the cumulative incidence of recurrence was 16.6% (CI 13.5-20.3), with median time to recurrence of 13.0 months (IQR 6.0-26.0). Factors independently associated with PRS were early recurrence (47.6%), treatment with sorafenib and surgery/trans-arterial chemoembolization (TACE). Patients who underwent any treatment presented "early recurrences" less frequently, and more extrahepatic metastasis. This unbalanced distribution was included in the propensity score matching, with correct calibration and discrimination (receiving operator curve of 0.81 [CI 0.72;0.88]). After matching, the adjusted effect on PRS for any treatment was HR of 0.2 (0.10;0.33); P < .0001, for sorafenib therapy HR of 0.4 (0.27;0.77); P = .003, and for surgery/TACE HR of 0.4 (0.18;0.78); P = .009. Conclusion: Although early recurrence was associated with worse outcome, even in this population, systemic or locoregional treatments were associated with better PRS. Mención de responsabilidad : Claudia Maccali, Aline L Chagas, Ilka Boin, Emilio Quiñonez, Sebastián Marciano, Mario Vilatobá, Adriana Varón, Margarita Anders, Sergio Hoyos Duque, Agnaldo S Lima, Josemaría Menendez, Martín Padilla-Machaca, Jaime Poniachik, Rodrigo Zapata, Martín Maraschio, Ricardo Chong Menéndez, Linda Muñoz, Diego Arufe, Rodrigo Figueroa, Alejandro Soza, Martín Fauda, Simone R Perales, Rodrigo Vergara Sandoval, Carla Bermudez, Oscar Beltran, Isabel Arenas Hoyos, Lucas McCormack, Francisco Juan Mattera, Adrián Gadano, Jose H Parente García , Claudia Megumi Tani, Luiz Augusto Carneiro D'Albuquerque, Flair J Carrilho, Marcelo Silva, Federico Piñero Referencia : Liver Int. 2021 Apr;41(4):851-862. DOI (Digital Object Identifier) : 10.1111/liv.14736 PMID : 33217193 En línea : https://onlinelibrary.wiley.com/doi/10.1111/liv.14736 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Recurrence of hepatocellular carcinoma after liver transplantation: Prognostic and predictive factors of survival in a Latin American cohort [documento electrónico] / Sergio Iván Hoyos Duque, Autor asociado al HPTU . - 2021.
Obra : Liver International
Idioma : Inglés (eng)
Palabras clave : hepatocellular carcinoma liver transplantation prognosis recurrence treatment Resumen : Background & aim: Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) has a poor prognosis, and the adjusted effect of different treatments on post-recurrence survival (PRS) has not been well defined. This study aims to evaluate prognostic and predictive variables associated with PRS. Methods: This Latin American multicenter retrospective cohort study included HCC patients who underwent LT between the years 2005-2018. We evaluated the effect of baseline characteristics at time of HCC recurrence diagnosis and PRS (Cox regression analysis). Early recurrences were those occurring within 12 months of LT. To evaluate the adjusted treatment effect for HCC recurrence, a propensity score matching analysis was performed to assess the probability of having received any specific treatment for recurrence. Results: From a total of 1085 transplanted HCC patients, the cumulative incidence of recurrence was 16.6% (CI 13.5-20.3), with median time to recurrence of 13.0 months (IQR 6.0-26.0). Factors independently associated with PRS were early recurrence (47.6%), treatment with sorafenib and surgery/trans-arterial chemoembolization (TACE). Patients who underwent any treatment presented "early recurrences" less frequently, and more extrahepatic metastasis. This unbalanced distribution was included in the propensity score matching, with correct calibration and discrimination (receiving operator curve of 0.81 [CI 0.72;0.88]). After matching, the adjusted effect on PRS for any treatment was HR of 0.2 (0.10;0.33); P < .0001, for sorafenib therapy HR of 0.4 (0.27;0.77); P = .003, and for surgery/TACE HR of 0.4 (0.18;0.78); P = .009. Conclusion: Although early recurrence was associated with worse outcome, even in this population, systemic or locoregional treatments were associated with better PRS. Mención de responsabilidad : Claudia Maccali, Aline L Chagas, Ilka Boin, Emilio Quiñonez, Sebastián Marciano, Mario Vilatobá, Adriana Varón, Margarita Anders, Sergio Hoyos Duque, Agnaldo S Lima, Josemaría Menendez, Martín Padilla-Machaca, Jaime Poniachik, Rodrigo Zapata, Martín Maraschio, Ricardo Chong Menéndez, Linda Muñoz, Diego Arufe, Rodrigo Figueroa, Alejandro Soza, Martín Fauda, Simone R Perales, Rodrigo Vergara Sandoval, Carla Bermudez, Oscar Beltran, Isabel Arenas Hoyos, Lucas McCormack, Francisco Juan Mattera, Adrián Gadano, Jose H Parente García , Claudia Megumi Tani, Luiz Augusto Carneiro D'Albuquerque, Flair J Carrilho, Marcelo Silva, Federico Piñero Referencia : Liver Int. 2021 Apr;41(4):851-862. DOI (Digital Object Identifier) : 10.1111/liv.14736 PMID : 33217193 En línea : https://onlinelibrary.wiley.com/doi/10.1111/liv.14736 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001640 AC-2020-134 Archivo digital Producción Científica Artículos científicos Disponible International and multicenter real‐world study of sorafenib‐treated patients with hepatocellular carcinoma under dialysis / Juan Ignacio Marín Zuluaga
Título : International and multicenter real‐world study of sorafenib‐treated patients with hepatocellular carcinoma under dialysis Tipo de documento : documento electrónico Autores : Juan Ignacio Marín Zuluaga, Autor asociado al HPTU Fecha de publicación : 2020 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : Hepatocellular carcinoma sorafenib dialysis adverse events safety survival Resumen : Background & Aims: Information on safety and efficacy of systemic treatment in patients with hepatocellular carcinoma (HCC) under dialysis are limited due to patient exclusion from clinical trials. Thus, we aimed to evaluate the rate, prevalence, tolerability, and outcome of sorafenib in this population. Methods: We report a multicenter study comprising patients from Latin America and Europe. Patients treated with sorafenib were enrolled; demographics, dose modifications, adverse events (AEs), treatment duration, and outcome of patients undergoing dialysis were recorded. Results: As of March 2018, 6156 HCC patients were treated in 44 centres and 22 patients were concomitantly under dialysis (0.36%). The median age was 65.5 years, 40.9% had hepatitis C, 75% had Child‐Pugh A, and 85% were Barcelona Clinic Liver Cancer‐C. The median time to first dose modification, treatment duration and overall survival rate were 2.4 months (interquartile ranges [IQR], 0.8‐3.8), 10.8 months (IQR, 4.5‐16.9), and 17.5 months (95% CI, 7.2‐24.5), respectively. Seventeen patients required at least 1 dose modification. The main causes of first dose modification were asthenia/worsening of Eastern Cooperative Oncology Group‐Performance Status and diarrhoea. At the time of death or last follow‐up, four patients were still on treatment and 18 had discontinued sorafenib: 14 were due to tumour progression, 2 were sorafenib‐related, and 2 were non‐sorafenib‐related AE. Conclusions: The outcomes observed in this cohort seem comparable to those in the non‐dialysis population. Thus, to the best of our knowledge, this is the largest and most informative dataset regarding systemic treatment outcomes in HCC patients undergoing dialysis. Mención de responsabilidad : Álvaro Díaz-González, Marco Sanduzzi-Zamparelli, Leonardo G da Fonseca, Giovan G Di Costanzo, Rogerio Alves, Massimo Iavarone, Cassia Leal, Rodolfo Sacco, Ana M Matilla, Manuel Hernández-Guerra, Gabriel Aballay Soteras, Marcus-Alexander Wörns, Matthias Pinter, María Varela, Morten Ladekarl, Aline L Chagas, Beatriz Mínguez, Juan I Arenas, Alessandro Granito, Yolanda Sánchez-Torrijos, Ángela Rojas, Carlos Rodríguez de Lope, Mario R Alvares-da-Silva, Sonia Pascual, Lorenza Rimassa, José L Lledó, Carlos Huertas, Bruno Sangro, Edoardo G Giannini, Manuel Delgado, Mercedes Vergara, Christie Perelló, Alberto Lue, Margarita Sala, Adolfo Gallego, Susanna Coll, Tania Hernáez, Federico Piñero, Gustavo Pereira, Alex França, Juan Marín, Margarita Anders, Vivianne Mello, Mar Lozano, Jean C Nault, Josemaría Menéndez, Ignacio García Juárez, Jordi Bruix, María Reig Referencia : Liver Int. 2020 Jun;40(6):1467-1476. DOI (Digital Object Identifier) : 10.1111/liv.14436 PMID : 32170821 En línea : https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.14436 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis International and multicenter real‐world study of sorafenib‐treated patients with hepatocellular carcinoma under dialysis [documento electrónico] / Juan Ignacio Marín Zuluaga, Autor asociado al HPTU . - 2020.
Obra : Liver International
Idioma : Inglés (eng)
Palabras clave : Hepatocellular carcinoma sorafenib dialysis adverse events safety survival Resumen : Background & Aims: Information on safety and efficacy of systemic treatment in patients with hepatocellular carcinoma (HCC) under dialysis are limited due to patient exclusion from clinical trials. Thus, we aimed to evaluate the rate, prevalence, tolerability, and outcome of sorafenib in this population. Methods: We report a multicenter study comprising patients from Latin America and Europe. Patients treated with sorafenib were enrolled; demographics, dose modifications, adverse events (AEs), treatment duration, and outcome of patients undergoing dialysis were recorded. Results: As of March 2018, 6156 HCC patients were treated in 44 centres and 22 patients were concomitantly under dialysis (0.36%). The median age was 65.5 years, 40.9% had hepatitis C, 75% had Child‐Pugh A, and 85% were Barcelona Clinic Liver Cancer‐C. The median time to first dose modification, treatment duration and overall survival rate were 2.4 months (interquartile ranges [IQR], 0.8‐3.8), 10.8 months (IQR, 4.5‐16.9), and 17.5 months (95% CI, 7.2‐24.5), respectively. Seventeen patients required at least 1 dose modification. The main causes of first dose modification were asthenia/worsening of Eastern Cooperative Oncology Group‐Performance Status and diarrhoea. At the time of death or last follow‐up, four patients were still on treatment and 18 had discontinued sorafenib: 14 were due to tumour progression, 2 were sorafenib‐related, and 2 were non‐sorafenib‐related AE. Conclusions: The outcomes observed in this cohort seem comparable to those in the non‐dialysis population. Thus, to the best of our knowledge, this is the largest and most informative dataset regarding systemic treatment outcomes in HCC patients undergoing dialysis. Mención de responsabilidad : Álvaro Díaz-González, Marco Sanduzzi-Zamparelli, Leonardo G da Fonseca, Giovan G Di Costanzo, Rogerio Alves, Massimo Iavarone, Cassia Leal, Rodolfo Sacco, Ana M Matilla, Manuel Hernández-Guerra, Gabriel Aballay Soteras, Marcus-Alexander Wörns, Matthias Pinter, María Varela, Morten Ladekarl, Aline L Chagas, Beatriz Mínguez, Juan I Arenas, Alessandro Granito, Yolanda Sánchez-Torrijos, Ángela Rojas, Carlos Rodríguez de Lope, Mario R Alvares-da-Silva, Sonia Pascual, Lorenza Rimassa, José L Lledó, Carlos Huertas, Bruno Sangro, Edoardo G Giannini, Manuel Delgado, Mercedes Vergara, Christie Perelló, Alberto Lue, Margarita Sala, Adolfo Gallego, Susanna Coll, Tania Hernáez, Federico Piñero, Gustavo Pereira, Alex França, Juan Marín, Margarita Anders, Vivianne Mello, Mar Lozano, Jean C Nault, Josemaría Menéndez, Ignacio García Juárez, Jordi Bruix, María Reig Referencia : Liver Int. 2020 Jun;40(6):1467-1476. DOI (Digital Object Identifier) : 10.1111/liv.14436 PMID : 32170821 En línea : https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.14436 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001332 AC-2020-036 Archivo digital Producción Científica Artículos científicos Disponible Lenvatinib as first-line therapy for recurrent hepatocellular carcinoma after liver transplantation: Is the current evidence applicable to these patients? / Juan Ignacio Marín Zuluaga
Título : Lenvatinib as first-line therapy for recurrent hepatocellular carcinoma after liver transplantation: Is the current evidence applicable to these patients? Tipo de documento : documento electrónico Autores : Juan Ignacio Marín Zuluaga, Autor asociado al HPTU Fecha de publicación : 2020 Títulos uniformes : World Journal of Transplantation Idioma : Inglés (eng) Palabras clave : Liver transplantation Recurrence Systemic therapies Hepatocellular carcinoma Resumen : Liver transplantation (LT) is one of the leading curative therapies for hepatocellular carcinoma (HCC). Despite recent optimization of transplant selection criteria, including alpha-feto protein, HCC recurrence after LT is still the leading cause of death in these patients. During the last decades, effective systemic treatments for HCC, including tyrosine kinase inhibitors and immunotherapy, have been approved. We describe the clinical scenario of a patient with recurrence of HCC five years after LT, who received lenvatinib as first-line systemic therapy to introduce systemic treatment options in this clinical setting. In this opinion review, we detail first and second-line systemic treatment options, focusing on those feasible for patients with recurrent HCC after LT. Several trials have evaluated new drugs to treat HCC patients in first and second-line therapy, but patients with recurrent HCC after LT have been excluded from these trials. Consequently, most of the evidence comes from observational retrospective studies. Whether tyrosine kinase inhibitors will remain the primary therapeutic approach in these patients, due to a relative contraindication for immunotherapy, may be clarified in the near future. Mención de responsabilidad : Federico Piñero, Marcos Thompson, Juan Ignacio Marín, Marcelo Silva Referencia : World J Transplant. 2020 Nov 28;10(11):297-306. DOI (Digital Object Identifier) : 10.5500/wjt.v10.i11.297 PMID : 33312891 Derechos de uso : CC BY-NC En línea : https://www.wjgnet.com/2220-3230/full/v10/i11/297.htm Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Lenvatinib as first-line therapy for recurrent hepatocellular carcinoma after liver transplantation: Is the current evidence applicable to these patients? [documento electrónico] / Juan Ignacio Marín Zuluaga, Autor asociado al HPTU . - 2020.
Obra : World Journal of Transplantation
Idioma : Inglés (eng)
Palabras clave : Liver transplantation Recurrence Systemic therapies Hepatocellular carcinoma Resumen : Liver transplantation (LT) is one of the leading curative therapies for hepatocellular carcinoma (HCC). Despite recent optimization of transplant selection criteria, including alpha-feto protein, HCC recurrence after LT is still the leading cause of death in these patients. During the last decades, effective systemic treatments for HCC, including tyrosine kinase inhibitors and immunotherapy, have been approved. We describe the clinical scenario of a patient with recurrence of HCC five years after LT, who received lenvatinib as first-line systemic therapy to introduce systemic treatment options in this clinical setting. In this opinion review, we detail first and second-line systemic treatment options, focusing on those feasible for patients with recurrent HCC after LT. Several trials have evaluated new drugs to treat HCC patients in first and second-line therapy, but patients with recurrent HCC after LT have been excluded from these trials. Consequently, most of the evidence comes from observational retrospective studies. Whether tyrosine kinase inhibitors will remain the primary therapeutic approach in these patients, due to a relative contraindication for immunotherapy, may be clarified in the near future. Mención de responsabilidad : Federico Piñero, Marcos Thompson, Juan Ignacio Marín, Marcelo Silva Referencia : World J Transplant. 2020 Nov 28;10(11):297-306. DOI (Digital Object Identifier) : 10.5500/wjt.v10.i11.297 PMID : 33312891 Derechos de uso : CC BY-NC En línea : https://www.wjgnet.com/2220-3230/full/v10/i11/297.htm Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001596 AC-2020-102 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
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