The challenge of offering potentially curative treatment to patients with esophageal cancer and a history of liver transplantation: A literature review and case report.

Halle-Smith, James M, Hall, Lewis A, Innominato, Pasquale F, Wadhwani, Sharan, Perera, M Thamara P R and Griffiths, Ewen A (2021) The challenge of offering potentially curative treatment to patients with esophageal cancer and a history of liver transplantation: A literature review and case report. Surgery. ISSN 1532-7361. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: http://www.journals.elsevier.com/surgery/

Abstract

BACKGROUND

With survival after liver transplantation continuing to improve, effective and evidence-based treatment of malignancies in this patient group is needed as a matter of urgency. Treatment outcomes for esophageal cancer, a challenging malignancy to treat in otherwise fit and well patients, after liver transplant are rarely reported.

METHODS

A systematic literature review was performed according to the PRISMA guidance to identify studies reporting outcomes of radical esophageal cancer treatment in patients with liver transplant. Management strategies and oncological outcomes were compared with a case managed at our institution.

RESULTS

Six studies were identified for review, and the outcomes of 13 patients were collated. The most common indication for liver transplant was alcohol-related liver disease (62%), and the most common tumor type was adenocarcinoma (54%). Neoadjuvant chemotherapy was delivered safely in 23% of cases in the literature and in the case managed at our institution. The median time from liver transplant to esophagectomy was 46 months, and the majority of patients underwent an Ivor-Lewis esophagectomy. The median follow-up from esophagectomy was 17 months, with a pooled 1-year survival of 77% and recurrence rate of 38%. This was comparable with corresponding rates reported for nontransplanted patients.

CONCLUSION

This case report and systematic review demonstrates that radical treatment of esophageal cancer after liver transplantation is not only technically feasible when managed by expert multidisciplinary teams but that it also improves survival. Routine surveillance of liver transplant patients with evidence of Barrett's preoperatively should be considered and close involvement of appropriate specialists in individual treatment planning is vital to acceptable outcomes.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QZ Pathology. Oncology
WI Digestive system. Gastroenterology
WN Medical imaging. Radiology
Divisions: Planned IP Care > Gastroentrology
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 03 Feb 2021 11:01
Last Modified: 03 Feb 2021 11:01
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3929

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