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 language | English |
|---|---|
| Pages (from-to) | 181-200 |
| Number of pages | 20 |
| Journal | Seminars in Liver Disease |
| Volume | 25 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - May 2005 |
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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 journal › Article
}
TY - JOUR
T1 - Resection and liver transplantation for hepatocellular carcinoma
AU - Llovet, Josep M.
AU - Schwartz, Myron
AU - Mazzaferro, Vincenzo
PY - 2005/5
Y1 - 2005/5
N2 - 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.
AB - 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.
KW - Adjuvant treatments
KW - Hepatocellular carcinoma
KW - Liver transplantation
KW - Living donor liver transplantation
KW - Resection
UR - http://www.scopus.com/inward/record.url?scp=20344367769&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=20344367769&partnerID=8YFLogxK
U2 - 10.1055/s-2005-871198
DO - 10.1055/s-2005-871198
M3 - Article
C2 - 15918147
AN - SCOPUS:20344367769
VL - 25
SP - 181
EP - 200
JO - Seminars in Liver Disease
JF - Seminars in Liver Disease
SN - 0272-8087
IS - 2
ER -