Liver transplantation for hepatocellular carcinoma

Citation
H. Bismuth et al., Liver transplantation for hepatocellular carcinoma, SEM LIV DIS, 19(3), 1999, pp. 311-322
Citations number
52
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
SEMINARS IN LIVER DISEASE
ISSN journal
02728087 → ACNP
Volume
19
Issue
3
Year of publication
1999
Pages
311 - 322
Database
ISI
SICI code
0272-8087(1999)19:3<311:LTFHC>2.0.ZU;2-7
Abstract
Liver transplantation for hepatocellular carcinoma (HCC) in patients with c irrhosis is a radical treatment of the tumor and associated precancerous st ate. It is potentially curative in a proportion of patients. The outcomes o f early studies of liver transplantation in this indication were initially unfavorable. Selection of transplant candidates at an early stage, in the a bsence of extrahepatic spread, gives better survival than surgical resectio n and alternative nonsurgical treatments. Transarterial chemoembolization c art be used for preoperative control of the disease. Adjuvant chemotherapy may be indicated in the postoperative period for the prevention of recurren ce in patients with histologic features of invasiveness in the surgical spe cimen. Liver transplantation as the treatment of choice for early HCC in sc reening programs in cirrhotic patients may become limited by graft availabi lity as the numbers of hepatitis C-related cases increase. Resection may be indicated if the waiting time is likely to be long.