However, there remains concern over the potential for increased difficulty of transplantation following a prior resection and postoperative complications to negate the benefits of an SLT. We propose to evaluate the outcomes of SLT for patients with recurrent HCC following initial treatment with primary hepatic resection. In this review, we seek to investigate using a systematic literature examination the morbidity,

mortality, and survival outcomes of this therapeutic Hormones antagonist strategy. A literature search was last conducted on December 1, 2012 using Pubmed, Embase, and Medline databases (January 2000–November 2012). The search terms used to locate studies were “salvage,” “secondary,” “liver transplant,” “liver transplantation,” and “recurrent hepatocellular carcinoma.” The search was limited

to English-language articles and to humans. All relevant journal articles and conference abstracts identified were assessed with application of inclusion and exclusion criteria. Where there was insufficient information provided by the abstract or ambiguity of inclusion criteria, full-text articles were retrieved for further assessment. The reference lists of articles identified were manually searched to locate other articles of relevance. Selection criteria www.selleckchem.com/products/mi-503.html were as follows: (i) all studies > 5 patients, (ii) initially treated with hepatic resection, (iii) adopting SLT for recurrent HCC, and (iv) sufficient data to be included in either perioperative morbidity and mortality or longer-term survival tabulation. Where multiple treatments for primary disease

recurrence was employed, reporting of outcome data must be separate. We excluded review articles, case reports, editorials, and letters. Where multiple publications from the same institution were identified, only the most recent update with the largest number of patients or longer follow-up group was included. Where conference abstracts and publications employed the same study cohort, the more recent was included. Studies were evaluated and categorized according to their level of evidence, where level I evidence: medchemexpress randomized controlled trials; level II evidence: nonrandomized controlled clinical trials or well-designed cohort studies; and level III evidence: observational studies, as described by the US Preventive Services Task Force. The studies were independently and critically appraised by two reviewers (DLC and TCC). Data of interest included study characteristics, patient demographics, disease characteristics, perioperative morbidity and mortality, disease recurrence, disease-free survival, and overall survival data. All data were extracted and tabulated from the relevant articles’ texts, tables, and figures. Data were presented as median (range). Discrepancies were resolved by discussion and consensus. Meta-analysis was inappropriate due to the lack of a comparative arm in most studies.