Resection and liver transplantation for hepatocellular carcinoma

Josep M. Llovet, Myron Schwartz, Vincenzo Mazzaferro

Research output: Contribution to journalArticle

646 Citations (Scopus)

Abstract

Surveillance programs in cirrhotic patients enable the detection of hepatocellular carcinoma (HCC) at early stages, when the tumor is amenable to curative treatments (60% of cases in Japan; 25 to 40% in Europe and the United States). Resection is the mainstay of treatment in noncirrhotic patients and in cirrhotics with well-preserved liver function. In modern series, a perioperative mortality ≤ 3% and 5-year survival rates above 50% are expected. Tumor recurrence complicates half of the cases at 3 years, but there is no unquestionable preventive treatment. Liver transplantation provides excellent outcomes applying the Milan criteria (single nodule ≤ 5 cm or two or three nodules ≤ 3 cm), with 5-year survival rates of 70% and low recurrence rates. Although expansion of selection criteria is appealing, it should be assessed in the setting of prospective well-designed studies. Intention-to-treat analysis has shown that wide extended indications lead to 25% 5-year survival rates. Living donor liver transplantation is having a minor impact in HCC management. Molecular markers are needed to better select the candidates for surgery.

Original languageEnglish
Pages (from-to)181-200
Number of pages20
JournalSeminars in Liver Disease
Volume25
Issue number2
DOIs
Publication statusPublished - May 2005

Fingerprint

Liver Transplantation
Hepatocellular Carcinoma
Survival Rate
Recurrence
Intention to Treat Analysis
Living Donors
Patient Selection
Neoplasms
Japan
Therapeutics
Mortality
Liver

Keywords

  • Adjuvant treatments
  • Hepatocellular carcinoma
  • Liver transplantation
  • Living donor liver transplantation
  • Resection

ASJC Scopus subject areas

  • Hepatology

Cite this

Resection and liver transplantation for hepatocellular carcinoma. / Llovet, Josep M.; Schwartz, Myron; Mazzaferro, Vincenzo.

In: Seminars in Liver Disease, Vol. 25, No. 2, 05.2005, p. 181-200.

Research output: Contribution to journalArticle

Llovet, Josep M. ; Schwartz, Myron ; Mazzaferro, Vincenzo. / Resection and liver transplantation for hepatocellular carcinoma. In: Seminars in Liver Disease. 2005 ; Vol. 25, No. 2. pp. 181-200.
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