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Article: Treatment before liver transplantation for HCC

TitleTreatment before liver transplantation for HCC
Authors
KeywordsDownstaging
Dropout
Hepatocellular carcinoma
Radiofrequency ablation
Resection
Transarterial chemoembolization
Transplantation
Issue Date2008
PublisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org
Citation
Annals Of Surgical Oncology, 2008, v. 15 n. 4, p. 993-1000 How to Cite?
AbstractLiver transplantation (LT) which is currently an established therapy for sma1l, early stage hepatocellular carcinoma (HCC) in patients with cirrhosis requires in most cases long waiting period. Tumor development during the waiting period may be associated with vascular invasion which is a strong factor of postoperative recurrence. Therefore, local treatment of the tumor including trans-arterial chemoembolization (TACE), percutaneous radiofrequency (RF) or partial liver resection can be used before transplantation. In the present paper we reviewed the efficacy of these treatments prior to LT. Although, TACE induced complete tumor necrosis in some patients there is no convincing arguments showing that this treatment reduces the rate of drop out before LT, nor improves the survival after LT. Although, RF can induce complete necrosis in the majority of small tumors (<2.5 cm), there is no data demonstrating that this treatment reduce the rate of drop out before LT, nor improves the survival after LT. It has been showed that both short and long term survival after LT was not compromised by previous partial liver resection of HCC. However, there is no data demonstrating that liver resection before LT, which can be used either as a bridge treatment or as a primary treatment, improves the survival after LT. The current data suggest that there is no role for pre-transplant therapy for HCC within Milano criteria transplanted within six months. On the opposite, if the waiting time is predicted to be prolonged, the risk of tumor progression and either drop-off from the list or interval dissemination with post-transplant tumor recurrence is recognized. In this setting, bridge therapy can reduce that risk but its efficacy has to be determined. © 2008 Society of Surgical Oncology.
Persistent Identifierhttp://hdl.handle.net/10722/83885
ISSN
2023 Impact Factor: 3.4
2023 SCImago Journal Rankings: 1.037
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorBelghiti, Jen_HK
dc.contributor.authorCarr, BIen_HK
dc.contributor.authorGreig, PDen_HK
dc.contributor.authorLencioni, Ren_HK
dc.contributor.authorPoon, RTen_HK
dc.date.accessioned2010-09-06T08:46:23Z-
dc.date.available2010-09-06T08:46:23Z-
dc.date.issued2008en_HK
dc.identifier.citationAnnals Of Surgical Oncology, 2008, v. 15 n. 4, p. 993-1000en_HK
dc.identifier.issn1068-9265en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83885-
dc.description.abstractLiver transplantation (LT) which is currently an established therapy for sma1l, early stage hepatocellular carcinoma (HCC) in patients with cirrhosis requires in most cases long waiting period. Tumor development during the waiting period may be associated with vascular invasion which is a strong factor of postoperative recurrence. Therefore, local treatment of the tumor including trans-arterial chemoembolization (TACE), percutaneous radiofrequency (RF) or partial liver resection can be used before transplantation. In the present paper we reviewed the efficacy of these treatments prior to LT. Although, TACE induced complete tumor necrosis in some patients there is no convincing arguments showing that this treatment reduces the rate of drop out before LT, nor improves the survival after LT. Although, RF can induce complete necrosis in the majority of small tumors (<2.5 cm), there is no data demonstrating that this treatment reduce the rate of drop out before LT, nor improves the survival after LT. It has been showed that both short and long term survival after LT was not compromised by previous partial liver resection of HCC. However, there is no data demonstrating that liver resection before LT, which can be used either as a bridge treatment or as a primary treatment, improves the survival after LT. The current data suggest that there is no role for pre-transplant therapy for HCC within Milano criteria transplanted within six months. On the opposite, if the waiting time is predicted to be prolonged, the risk of tumor progression and either drop-off from the list or interval dissemination with post-transplant tumor recurrence is recognized. In this setting, bridge therapy can reduce that risk but its efficacy has to be determined. © 2008 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.subjectDownstagingen_HK
dc.subjectDropouten_HK
dc.subjectHepatocellular carcinomaen_HK
dc.subjectRadiofrequency ablationen_HK
dc.subjectResectionen_HK
dc.subjectTransarterial chemoembolizationen_HK
dc.subjectTransplantationen_HK
dc.titleTreatment before liver transplantation for HCCen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1068-9265&volume=15&issue=4&spage=993&epage=1000&date=2008&atitle=Treatment+before+liver+transplantation+for+HCCen_HK
dc.identifier.emailPoon, RT: poontp@hkucc.hku.hken_HK
dc.identifier.authorityPoon, RT=rp00446en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1245/s10434-007-9787-8en_HK
dc.identifier.pmid18236111en_HK
dc.identifier.scopuseid_2-s2.0-40549118488en_HK
dc.identifier.hkuros151015en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-40549118488&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume15en_HK
dc.identifier.issue4en_HK
dc.identifier.spage993en_HK
dc.identifier.epage1000en_HK
dc.identifier.isiWOS:000253896000008-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridBelghiti, J=35403099400en_HK
dc.identifier.scopusauthoridCarr, BI=7202640909en_HK
dc.identifier.scopusauthoridGreig, PD=7006982425en_HK
dc.identifier.scopusauthoridLencioni, R=35392831700en_HK
dc.identifier.scopusauthoridPoon, RT=7103097223en_HK
dc.identifier.issnl1068-9265-

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