Abstract
The evidence base is poor overall because of the limitedsample sizes of most studies and the heterogeneouscohorts and variables, and few have well-plannedand statistically valid study designs. No studies haveaccounted for the effects of underlying liver diseaseseither before or after LT on overall outcomes, and onlya few studies have assessed the effects of adjuvanttreatments before transplantation. In the majority ofthe reports, the follow-up time is not sufficient forassessing 5-year survival rates. Many have used histologicalfindings from explanted livers to stagepatients, but this has little utility for preoperativestaging and selection for LT. The presence of vascularinvasion, the tumor number and size (also calculatedas the TTV), and the AFP level have most consistentlybeen associated with increased recurrence rates anddiminished survival after LT. Most studies havereported acceptable survival rates for patients meetingthe UCSF criteria; however, it is notable that there aredocumented survival rates for patients with HCCtumors beyond the UCSF criteria that would bemore than acceptable in any other surgicaloncology setting. It is the potential to affect candidateswithout HCC who are also competing for thelimited pool of donor organs that limits the criteria forselecting patients with HCC for LT, especially whenwe consider LT for patients with more advancedstages of HCC.
| Original language | English |
|---|---|
| Journal | Liver Transplantation |
| Volume | 17 |
| Issue number | SUPPL. 2 |
| DOIs | |
| Publication status | Published - Oct 2011 |
Fingerprint
ASJC Scopus subject areas
- Surgery
- Transplantation
- Hepatology
Cite this
Summary of candidate selection and expanded criteria for liver transplantation for hepatocellular carcinoma : A review and consensus statement. / Prasad, K. Raj; Young, Richard S.; Burra, Patrizia; Zheng, Shu Sen; Mazzaferro, Vincenzo; Bog Moon, Duk; Freeman, Richard B.
In: Liver Transplantation, Vol. 17, No. SUPPL. 2, 10.2011.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Summary of candidate selection and expanded criteria for liver transplantation for hepatocellular carcinoma
T2 - A review and consensus statement
AU - Prasad, K. Raj
AU - Young, Richard S.
AU - Burra, Patrizia
AU - Zheng, Shu Sen
AU - Mazzaferro, Vincenzo
AU - Bog Moon, Duk
AU - Freeman, Richard B.
PY - 2011/10
Y1 - 2011/10
N2 - The evidence base is poor overall because of the limitedsample sizes of most studies and the heterogeneouscohorts and variables, and few have well-plannedand statistically valid study designs. No studies haveaccounted for the effects of underlying liver diseaseseither before or after LT on overall outcomes, and onlya few studies have assessed the effects of adjuvanttreatments before transplantation. In the majority ofthe reports, the follow-up time is not sufficient forassessing 5-year survival rates. Many have used histologicalfindings from explanted livers to stagepatients, but this has little utility for preoperativestaging and selection for LT. The presence of vascularinvasion, the tumor number and size (also calculatedas the TTV), and the AFP level have most consistentlybeen associated with increased recurrence rates anddiminished survival after LT. Most studies havereported acceptable survival rates for patients meetingthe UCSF criteria; however, it is notable that there aredocumented survival rates for patients with HCCtumors beyond the UCSF criteria that would bemore than acceptable in any other surgicaloncology setting. It is the potential to affect candidateswithout HCC who are also competing for thelimited pool of donor organs that limits the criteria forselecting patients with HCC for LT, especially whenwe consider LT for patients with more advancedstages of HCC.
AB - The evidence base is poor overall because of the limitedsample sizes of most studies and the heterogeneouscohorts and variables, and few have well-plannedand statistically valid study designs. No studies haveaccounted for the effects of underlying liver diseaseseither before or after LT on overall outcomes, and onlya few studies have assessed the effects of adjuvanttreatments before transplantation. In the majority ofthe reports, the follow-up time is not sufficient forassessing 5-year survival rates. Many have used histologicalfindings from explanted livers to stagepatients, but this has little utility for preoperativestaging and selection for LT. The presence of vascularinvasion, the tumor number and size (also calculatedas the TTV), and the AFP level have most consistentlybeen associated with increased recurrence rates anddiminished survival after LT. Most studies havereported acceptable survival rates for patients meetingthe UCSF criteria; however, it is notable that there aredocumented survival rates for patients with HCCtumors beyond the UCSF criteria that would bemore than acceptable in any other surgicaloncology setting. It is the potential to affect candidateswithout HCC who are also competing for thelimited pool of donor organs that limits the criteria forselecting patients with HCC for LT, especially whenwe consider LT for patients with more advancedstages of HCC.
UR - http://www.scopus.com/inward/record.url?scp=80053267175&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80053267175&partnerID=8YFLogxK
U2 - 10.1002/lt.22380
DO - 10.1002/lt.22380
M3 - Article
VL - 17
JO - Liver Transplantation
JF - Liver Transplantation
SN - 1527-6465
IS - SUPPL. 2
ER -