Oncology (Williston Park). 2020 Mar 19;34(3):692516.
Key Points • Recurrent HCC after OLT management is challenging and notoriously difficult. • High oncologic-risk patient identification and close follow-up are essential. • Recurrences diagnosed within the first 2 years after OLT can be classified as early-onset and are associated with poor prognosis. • Surgical resection should be the first curative attempt when it is technically feasible. • TACE in patients who have undergone OLT appears to be effective and safe. • Sorafenib can be used as systemic therapy in cases with multi-organ recurrence; newer therapies are emerging. • The benefit of immunosuppression with an mTOR inhibitor has not been established. • In the posttransplant setting, a combination treatment approach is warranted.
关键点
· 肝移植（OLT）后复发性肝细胞癌（HCC）的治疗极具挑战性，且预后极差。
· 对高肿瘤风险患者进行识别并密切随访非常重要。
· OLT 后 2 年内诊断的复发可归类为早期复发，与预后不良相关。
· 当技术可行时，外科切除应作为首选的治疗方法。
· 肝移植后患者的经导管肝动脉化疗栓塞术（TACE）似乎是有效且安全的。
· 索拉非尼可用于多器官复发的全身治疗；新的治疗方法正在出现。
· 应用 mTOR 抑制剂进行免疫抑制的获益尚未得到证实。
· 在移植后环境中，联合治疗方法是合理的。
