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Article: Optimal initial treatment for early hepatocellular carcinoma in patients with preserved liver function: Transplantation or resection?

TitleOptimal initial treatment for early hepatocellular carcinoma in patients with preserved liver function: Transplantation or resection?
Authors
Issue Date2007
PublisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org
Citation
Annals Of Surgical Oncology, 2007, v. 14 n. 2, p. 541-547 How to Cite?
AbstractPartial hepatic resection has been the mainstay of curative treatment for hepatocellular carcinoma (HCC) in cirrhotic patients with preserved liver function. Liver transplantation for HCC was initially developed as a treatment option for patients with unresectable tumors associated with Child B or C cirrhosis. However, in recent years, some authors have advocated liver transplantation even for resectable early HCC associated with Child A cirrhosis. Whether transplantation or liver resection is the optimal initial treatment for early HCC in compensated cirrhosis depends on the survival results and also the availability of liver grafts. Recent studies comparing liver resection and transplantation for early HCC in Child A cirrhotic patients demonstrated similar long-term survival. While liver transplantation is associated with a lower tumor recurrence rate, this benefit is counteracted by long-term complications such as immunosuppression related infections and neoplasms. Patients put on transplantation waiting list run a significant risk of tumor progression and dropout, while liver resection is immediately applicable to all. A premature liver transplantation may expose patients to the side effects of immunosuppression earlier than necessary. With the current shortage of liver grafts, advocating primary liver transplantation for patients with early HCC associated with compensated cirrhosis will increase waiting time of transplantation and further increases the chance of dropout. Resection first and salvage transplantation for recurrent tumors or liver failure has been shown to be a feasible strategy in the majority of patients, and this appears to be the optimal strategy with the best use of organs. © 2006 Society of Surgical Oncology.
Persistent Identifierhttp://hdl.handle.net/10722/83787
ISSN
2015 Impact Factor: 3.655
2015 SCImago Journal Rankings: 1.902
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPoon, RTPen_HK
dc.date.accessioned2010-09-06T08:45:12Z-
dc.date.available2010-09-06T08:45:12Z-
dc.date.issued2007en_HK
dc.identifier.citationAnnals Of Surgical Oncology, 2007, v. 14 n. 2, p. 541-547en_HK
dc.identifier.issn1068-9265en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83787-
dc.description.abstractPartial hepatic resection has been the mainstay of curative treatment for hepatocellular carcinoma (HCC) in cirrhotic patients with preserved liver function. Liver transplantation for HCC was initially developed as a treatment option for patients with unresectable tumors associated with Child B or C cirrhosis. However, in recent years, some authors have advocated liver transplantation even for resectable early HCC associated with Child A cirrhosis. Whether transplantation or liver resection is the optimal initial treatment for early HCC in compensated cirrhosis depends on the survival results and also the availability of liver grafts. Recent studies comparing liver resection and transplantation for early HCC in Child A cirrhotic patients demonstrated similar long-term survival. While liver transplantation is associated with a lower tumor recurrence rate, this benefit is counteracted by long-term complications such as immunosuppression related infections and neoplasms. Patients put on transplantation waiting list run a significant risk of tumor progression and dropout, while liver resection is immediately applicable to all. A premature liver transplantation may expose patients to the side effects of immunosuppression earlier than necessary. With the current shortage of liver grafts, advocating primary liver transplantation for patients with early HCC associated with compensated cirrhosis will increase waiting time of transplantation and further increases the chance of dropout. Resection first and salvage transplantation for recurrent tumors or liver failure has been shown to be a feasible strategy in the majority of patients, and this appears to be the optimal strategy with the best use of organs. © 2006 Society of Surgical Oncology.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.orgen_HK
dc.relation.ispartofAnnals of Surgical Oncologyen_HK
dc.subject.meshCarcinoma, Hepatocellular - pathology - surgeryen_HK
dc.subject.meshHepatectomy - adverse effectsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLiver - physiologyen_HK
dc.subject.meshLiver Failure - etiology - surgeryen_HK
dc.subject.meshLiver Function Testsen_HK
dc.subject.meshLiver Neoplasms - pathology - surgeryen_HK
dc.subject.meshLiver Transplantationen_HK
dc.subject.meshNeoplasm Recurrence, Local - surgeryen_HK
dc.subject.meshNeoplasm Stagingen_HK
dc.titleOptimal initial treatment for early hepatocellular carcinoma in patients with preserved liver function: Transplantation or resection?en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1068-9265&volume=14&issue=2&spage=541&epage=547&date=2007&atitle=Optimal+initial+treatment+for+early+hepatocellular+carcinoma+in+patients+with+preserved+liver+function:+transplantation+or+resection?en_HK
dc.identifier.emailPoon, RTP: poontp@hkucc.hku.hken_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1245/s10434-006-9156-zen_HK
dc.identifier.pmid17103069-
dc.identifier.scopuseid_2-s2.0-33846583593en_HK
dc.identifier.hkuros126249en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33846583593&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume14en_HK
dc.identifier.issue2en_HK
dc.identifier.spage541en_HK
dc.identifier.epage547en_HK
dc.identifier.isiWOS:000243765500037-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK

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