Following removal of duplicates, 101 abstracts were screened and 74 papers were excluded. The remaining 27 articles were reviewed to assess for eligibility. Five articles had insufficient patient numbers of inclusion.[9-13] Two articles were excluded due to larger case series from same research group.[14, 15] One article did not contain sufficient perioperative or long-term data for inclusion. Two other articles were excluded for heterogeneous treatment of primary disease and disease recurrence, and failure to present hepatic resection
and SLT results separately.[17, 18] A retrospective case series from China contained large numbers from a data registry but had poor data quality, with almost 1000 of their 17 000 transplants excluded for this reason. This article also included data from 54 transplant centers, even though only nine centers AZD5363 cell line had a volume of > 20 transplants over a 10-year period. The remaining 16 articles were included for this review, as outlined in the PRISMA flow diagram (Fig. 1).[20-35] None of the studies reviewed were randomized trials. There was a combination of class II (nonrandomized comparative or well-designed cohort studies) and class III (observational studies) evidence in the available literature. Table 1 summarizes
the data Venetoclax points included in relevant articles. In total, 319 patients from 16 different studies were reviewed. The median patient age was 51 years, range 44–63 years, and the majority were male (88%). The hepatitis B carrier status was positive in median 84% of patients, range 24–100%. The hepatitis C carrier status was positive in median 36%, range 0–33% of patients. Alcohol was the etiology of liver disease in median 9%, range 0–33% of patients. All patients reviewed had some degree of liver cirrhosis, Child-Pugh A (median 50%, range 28–100%), SPTLC1 B (median 33%, range 0–54%), or C (median 12%,
range 0–44%) (Table 2). The median tumor size was 3 cm, range 2.5–3.4 cm. The majority of tumors were solitary (median 81%, range 58–94%) and had well-differentiated histology (median 59%, range 0–94%). Microvascular involvement was more common than macrovascular (median 28%, range 0–53%, vs median 4%, range 0–13%) (Table 3). Only four studies (91 patients) published details on primary hepatic resection. Major hepatectomy was performed with 18–29% of patients. This was associated with minor morbidity in 19–41% of cases and a 0–6% mortality rate. Liver failure was noted in five patients (Table 4). Disease recurrence occurred in a median 54%, range 27–80% of patients following primary hepatic resection. Median time to recurrence was 21.4 months (range 14.5–34 months). The median tumor size was 2.6 cm (range 2–4.8 cm) at recurrence. Recurrences were solitary in 58% (range 27–89%) of patients and multiple in 42% (range 11–88%) of patients. The rate of SLT following recurrence was 41% (range 16–65%) (Table 5).