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Current role of surgery in treatment of early stage hepatocellular carcinoma: resection versus liver transplantation

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Authors
Yi, Nam-Joon; Suh, Kyung-Suk; Kim, Taehoon; Kim, Joohyun; Shin, Woo Young; Lee, Kuhn-Uk
Issue Date
2009-02-20
Publisher
Karger
Citation
Oncology. 2008;75 Suppl 1:124-128
Keywords
Carcinoma, Hepatocellular/pathology/*surgery*HepatectomyHumansImmunosuppressive Agents/adverse effects/economicsLiver Neoplasms/pathology/*surgery*Liver TransplantationNeoplasm StagingQuality of LifeSurvival AnalysisTreatment Outcome
Abstract
Hepatocellular carcinoma (HCC) is the most common malignancy of the liver and is most commonly associated with hepatitis B infection in Korea. Although liver resection is regarded as a potentially curative treatment option, it is only feasible in less than 20% of patients. The reason for this is that HCC arises in cirrhotic livers and is often multicentric. Liver transplantation (LT) which could be used in the treatment both of the tumor and background liver seems to be a rational approach for early stage patients with decompensated liver cirrhosis. Current good selection criteria of LT for HCC are the Milan criteria: 1 HCC nodule < or =5 cm in diameter or 3 nodules < or =3 cm. By restricting LT to patients within the Milan criteria, the 4-year disease-free survival rate was more than 80%, which is comparable to that of a transplant candidate without HCC. However, there are serious limitations for the wider application of LT for HCC: (1) organ shortage, (2) risk to a live donor, (3) high cost, and (4) lifelong immunosuppression. For this reason, for a patient with early stage HCC and with Child A cirrhosis in whom partial hepatectomy is possible, the choice of primary treatment with curative intent is still under debate.
ISSN
1423-0232 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19092282

http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=000173434&Ausgabe=242147&ProduktNr=223857&filename=000173434.pdf

https://hdl.handle.net/10371/67752
DOI
https://doi.org/10.1159/000173434
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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