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An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis
Published on: September 12, 2019
Treatment before liver transplantation for HCC
J Belghiti1, B I Carr, P D Greig
1HPB Surgery & Liver Transplantation Unit, Hospital Beaujon, 100 Bd du Gal Leclerc, 92110, Clichy, France. jacques.belghiti@bjn.aphp.fr
Annals of Surgical Oncology
|February 1, 2008
Summary
Pre-transplant therapies for early-stage liver cancer (HCC) before liver transplantation (LT) show limited benefit. While some treatments can reduce tumor size, evidence for improved survival or reduced dropout rates is lacking for extended waiting periods.
Area of Science:
- Hepatology
- Surgical Oncology
- Transplant Surgery
Background:
- Liver transplantation (LT) is a key treatment for early hepatocellular carcinoma (HCC) in cirrhotic patients.
- Long waiting times for LT can lead to tumor progression and vascular invasion, increasing recurrence risk.
- Pre-transplant locoregional therapies are used to manage HCC during the waiting period.
Purpose of the Study:
- To review the efficacy of pre-transplant locoregional therapies for HCC before LT.
- To evaluate the impact of trans-arterial chemoembolization (TACE), radiofrequency ablation (RF), and partial liver resection on patient outcomes.
- To determine the role of bridge therapies in managing HCC during LT waiting periods.
Main Methods:
- Review of existing literature on pre-transplant therapies for HCC.
- Analysis of studies evaluating TACE, RF, and partial liver resection efficacy.
- Assessment of impact on dropout rates, tumor recurrence, and patient survival.
Main Results:
- TACE and RF show potential for tumor necrosis but lack evidence for reducing dropout or improving survival post-LT.
- Partial liver resection does not compromise short or long-term survival but its benefit as a bridge therapy is unproven.
- No clear benefit for pre-transplant therapy in HCC patients meeting Milano criteria transplanted within six months.
Conclusions:
- Pre-transplant therapy for HCC within Milano criteria transplanted within six months is not currently indicated.
- For prolonged waiting times, bridge therapy may mitigate risks of tumor progression and recurrence, but its efficacy requires further determination.
- Further research is needed to establish the role and effectiveness of pre-transplant HCC treatments in specific patient populations.
