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Hepatocellular Cancer and Liver Transplantation: A Western Experience

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Multidisciplinary Treatment of Hepatocellular Carcinoma

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 190))

Abstract

Orthotopic liver transplantation is the preferred treatment option in patients with hepatocellular carcinoma developing in chronic liver disease. Unfortunately, based on classical transplantation criteria (Milan criteria), only a minority of patients with hepatocellular carcinoma are candidate to orthotopic liver transplantation. Major improvements in treatment strategy and surgical technique including the use of neoadjuvant locoregional therapies and progresses of post-transplant immunosuppressive treatment have contributed to safely expand transplantation criteria preserving acceptable surgical morbidity-mortality and good oncologic outcome. Further extension of transplantation criteria may have advantages including an increase in the number of transplant candidates and improvement of the prognosis of the disease and also disadvantages including an increase of surgical morbidity and deterioration of global oncologic outcome of orthotopic liver transplantation in hepatocellular carcinoma. In the future, identification of imaging or molecular prognostic markers could help to better define transplantation criteria.

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Abbreviations

AFP:

Alfa-fetoprotein

DFS:

Disease free survival

DS:

Down staging

HCC:

Hepatocellular carcinoma

IOBS:

Intraoperative blood salvage

IS:

Immunosuppression

IVC:

Inferior vena cava

LDLT:

Living donor LT

LT:

Liver transplantation

MC:

Milan criteria

NC-HCC:

HCC in non-cirrhotic liver

PEI:

Percutaneous ethanol injection

PLR:

Partial liver resection

RFA:

Radiofrequency ablation

TACE:

Transarterial chemo-embolization

UCSF:

University California San Francisco

VVB:

Veno-venous bypass

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Authors and Affiliations

  1. Department of Imaging - Interventional Radiology, Th.Starzl Unit of Abdominal Transplantation, University Hospitals St.-Luc, Université catholique de Louvain—UCL, Avenue Hippocrates 10, 1200, Brussels, Belgium

    Jan Lerut, Olivier Julliard, Olga Ciccarelli & Valerie Lannoy

  2. Department of Imaging, Cliniques Universitaires Saint-Luc, Brussels, Université catholique de Louvain (UCL), Brussels, Belgium

    Pierre Gofette

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  1. Jan Lerut
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  2. Olivier Julliard
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  3. Olga Ciccarelli
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  4. Valerie Lannoy
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  5. Pierre Gofette
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Correspondence to Jan Lerut .

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  1. M.D. Anderson Cancer Center, Dept. Surgical Oncology, University of Texas, Holcombe Blvd. 1515, Houston, 77030, Texas, USA

    Jean-Nicolas Vauthey

  2. , Dept. of Surgical Oncology, MD Anderson Cancer Center, Holcombe Boulevard, Unit 444 1515, Houston, 77030, USA

    Antoine Brouquet

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Lerut, J., Julliard, O., Ciccarelli, O., Lannoy, V., Gofette, P. (2013). Hepatocellular Cancer and Liver Transplantation: A Western Experience. In: Vauthey, JN., Brouquet, A. (eds) Multidisciplinary Treatment of Hepatocellular Carcinoma. Recent Results in Cancer Research, vol 190. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16037-0_9

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