Liver transplantation for hepatocellular carcinoma

Chung, Stephen W.; Toth, Julius L.; Rezieg, M; Cameron, Ross; Taylor, Bryce; Greig, Paul D.; Levy, Gary; Langer, Bernard

doi:10.1016/0002-9610(94)90208-9

Cited by 43 publications

(14 citation statements)

References 19 publications

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“…In addition to the Japanese reports, studies from Toronto and London have shown poor outcome after liver transplantation for the treatment of HCC patients with HBV. 29,30 We reviewed our own experience in patients with HCC and chronic hepatitis to determine if differences exist in preoperative status, pathological findings, and postoperative outcome between those with HBV and HCV infections treated in a setting where both resection and liver transplantation are considered.…”

Section: Abundant Epidemiological and Molecular Studies Have Linked Cmentioning

confidence: 99%

Comparison of Surgical Outcomes for Hepatocellular Carcinoma in Patients With Hepatitis B Versus Hepatitis C: A Western Experience

et al. 2000

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Based on preoperative liver function and tumor location, a much higher proportion of HCC patients with HBV were candidates for resection. Significant differences in preoperative status, tumor characteristics and disease-free survival exist between HCC patients with chronic HBV and HCV infection who have not yet reached end-stage liver disease. Serious consideration should be given to transplanting resectable HCC with concomitant HCV, especially in cases with small tumors.

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Section: Abundant Epidemiological and Molecular Studies Have Linked Cmentioning

confidence: 99%

Comparison of Surgical Outcomes for Hepatocellular Carcinoma in Patients With Hepatitis B Versus Hepatitis C: A Western Experience

et al. 2000

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“…The 5-year survival rate was !20% inHbsAg-positive (HBV antigen) transplanted patients reported by Chung et al [20]. Recurrent hepatitis infection was the cause of death in the majority of the cases.…”

Section: Liver Transplantation In the Treatment Of Hccmentioning

confidence: 89%

Current Status of Liver Transplantation for Treatment of Hepatocellular Carcinoma

Frilling

Malagó

Broelsch³

2001

Dig Dis

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Hepatocellular carcinoma accounts for more than 5% of all malignancies with a continuous increase worldwide. The most important risk factor is liver cirrhosis, frequently associated with hepatitis B virus or hepatitis C virus infection. Liver resection is the only treatment that can potentially achieve cure. In carefully selected patients with a tumor smaller than 5 cm the 5-year survival is around 50%. The presence of liver cirrhosis and portal hypertension limits the feasibility of hepatic resection. Child-Pugh A patients without major associated risk factors may be considered as the ideal target group for resection. A significant local disease recurrence rate of more than 70% at 5 years is the main problem of hepatic resection. Orthotopic liver transplantation offers the possibility of removing a potentially multicentric tumor and the underlying end-stage liver disease. Due to pure selection of suitable candidates the initial reports on the efficacy of liver replacement in a cohort of patients with hepatocellular carcinoma were disappointing. Taking the shortness of donor organs and the high posttransplant tumor recurrence rate into account, several groups developed criteria qualifying transplantation. A tumor size of >6 cm and gross intrahepatic portal vein involvement seem to be of significant prognostic importance. Patients with smaller solitary tumors or less than 3 tumors with a total tumor diameter of <8 cm have the same survival after transplantation as those with benign liver disease. Living donor liver transplantation offers a new approach to overcome the organ shortage and to theoretically extend the indication for transplantation in hepatocellular carcinoma.

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“…Para alguns a seropositividade do antígeno de superfície do vírus B da hepatite (HbsAg) não faz diferença (52) , para outros (8) , a evolução pós-transplante é melhor nos negativos e, mais ainda, contra-indicam o transplante nos positivos, pois a sobrevida de três anos nos primeiros foi de 69% contra 18% nos segundos, respectivamente.…”

Section: Estadiamento Dos Chcunclassified

Carcinoma hepatocelular: parte 2. Tratamento

Conte

2000

Arq. Gastroenterol.

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RESUMO -São revisadas as formas de tratamento, particularmente as ressecções cirúrgicas, a quimioembolização arterial e as injeções percutâneas de etanol e de ácido acético. Alguns aspectos relativos à dietaApenas 15 a 30% dos pacientes portadores de carcinoma hepatocelular (CHC) são passíveis de ressecção cirúrgica definitiva (7) e, mesmo assim, o número de recurrências é significativamente alto. RESSECÇÃO HEPÁTICA (EXPERIÊNCIA JAPONESA)MAKUUICHI et al. (34) , realizaram 367 hepatectomias em 352 pacientes, com mortalidade cirúrgica de 0,27% e mortalidade hospitalar de 0,82% e, obtiveram 5 anos de sobrevida média em 47,4% dos pacientes. Assim sendo, advogam como tratamento de eleição a ressecção cirúrgica para os pequenos cânceres, ao invés da sua alcoolização.FARGES et al. (12) acreditam que o melhor tratamento para os cânceres recurrentes após ressecção cirúrgica, deve ser o agressivo, com hepatectomias de repetição, associadas à quimioembolização e à injeção percutânea de etanol, nos casos irressecáveis. Obtiveram cinco anos de sobrevida média em 30% dos pacientes.OKUDA and The LIVER CANCER ..., em 4031 pacientes, conseguiram ressecar apenas 361 deles (9%), ou seja, aproximadamente 1 de cada 10 pacientes.The LIVER CANCER ...analisou estatisticamente 12.887 pacientes com câncer primário do fígado e baseou suas conclusões em 4765 casos comprovados histologicamente, afirmando que menos de 20% deles foram passíveis de ressecção. Nesse sentido, enfatizam a importância de tratamentos alternativos.OKUDA et al., em 229 pacientes que não receberam tratamento específico, tiveram sobrevida média de 1,6 meses,

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Liver transplantation for hepatocellular carcinoma

Cited by 43 publications

References 19 publications

Comparison of Surgical Outcomes for Hepatocellular Carcinoma in Patients With Hepatitis B Versus Hepatitis C: A Western Experience

Comparison of Surgical Outcomes for Hepatocellular Carcinoma in Patients With Hepatitis B Versus Hepatitis C: A Western Experience

Current Status of Liver Transplantation for Treatment of Hepatocellular Carcinoma

Carcinoma hepatocelular: parte 2. Tratamento

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