Liver Transplantation for Liver and Perihilar Neoplasms

Area of Science:

• Hepatobiliary oncology
• Transplant surgery
• Medical oncology

Background:

• Liver transplantation offers a curative option for select primary hepatobiliary malignancies.
• Surgical resection may be limited by disease biology or hepatic reserve.
• Current strategies involve radiographic criteria, biomarkers, and neoadjuvant therapies for patient selection.

Purpose of the Study:

• To review the role of liver transplantation in managing primary hepatobiliary malignancies.
• To discuss current selection criteria and treatment protocols.
• To explore future directions in liver transplant oncology.

Main Methods:

• Review of contemporary practices in liver transplantation for hepatocellular carcinoma and cholangiocarcinoma.
• Analysis of patient selection criteria, including radiographic and biomarker thresholds.
• Discussion of downstaging and neoadjuvant protocols.
• Examination of evolving allocation policies, living donor programs, and systemic therapy integration.

Main Results:

• Liver transplantation, in carefully selected patients, demonstrates improved overall survival compared to resection.
• Transplantation is associated with reduced recurrence rates for eligible patients.
• Evolving practices are enhancing the applicability and outcomes of liver transplant oncology.

Conclusions:

• Liver transplantation is a viable curative strategy for select hepatobiliary cancers.
• Rigorous patient selection and multidisciplinary approaches are crucial for successful outcomes.
• Future advancements in allocation, living donation, and systemic therapies will further shape liver transplant oncology.