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Hepatocellular carcinoma:Defining the place of surgery in an era of organ shortage 被引量:1

Hepatocellular carcinoma:Defining the place of surgery in an era of organ shortage
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摘要 Liver resection (LR) and transplantation offer the only potential chance of cure for patients with hepatocellular carcinoma (HCC). Historically, all patients were treated by hepatic resection. With the advent of liver transplantation (LT) patients with HCC were preferentially placed on the waiting list for LT. However, early experience with LT was associated with a high rate of tumour recurrence and poor long-term survival. The increasing scarcity of donor livers resulted in restrictions being placed on tumour size, and an improvement in patient survival. To date there have been no randomised clinical trials comparing LR to LT. We review the evidence supporting LR and/or LT for HCC and discuss the role of neoadjuvant therapy. The decision of whether to resect or transplant remains debatable and is often determined by centre experience, availability of LT and donor organs. Liver resection (LR) and transplantation offer the only potential chance of cure for patients with hepatocellular carcinoma (HCC). Historically, all patients were treated by hepatic resection. With the advent of liver transplantation (LT) patients with HCC were preferentially placed on the waiting list for LT. However, early experience with LT was associated with a high rate of tumour recurrence and poor long-term survival. The increasing scarcity of donor livers resulted in restrictions being placed on tumour size, and an improvement in patient survival. To date there have been no randomised clinical trials comparing LR to LT. We review the evidence supporting LR and/or LT for HCC and discuss the role of neoadjuvant therapy. The decision of whether to resect or transplant remains debatable and is often determined by centre experience, availability of LT and donor organs.
出处 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第28期4445-4453,共9页 世界胃肠病学杂志(英文版)
关键词 肝细胞癌 肝移植 肝切除术 辅助治疗 Hepatocellular carcinoma Liver transplantation Liver resection Adjuvant therapy Salvage liver transplantation Radiofrequency ablation Transarterial chemoembolization
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