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Liver transplantation for malignant disease

G J Gores1

  • 1Division of Gastroenterology and Internal Medicine, Mayo Clinic, Rochester, Minnesota.

Gastroenterology Clinics of North America
|June 1, 1993
PubMed
Summary

Orthotopic liver transplantation shows promise for select patients with early-stage liver cancer (hepatocellular carcinoma) and rare liver tumors. However, improved strategies are needed to prevent recurrence for broader application in malignant liver disease.

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Area of Science:

  • Hepatology and Transplant Surgery
  • Oncology
  • Gastroenterology

Background:

  • Identifying suitable candidates for liver transplantation among patients with primary malignant liver tumors is crucial for improving survival outcomes.
  • Orthotopic liver transplantation (OLT) is a potential curative option for specific liver malignancies.
  • Current challenges include suboptimal survival rates and disease recurrence in many patients undergoing OLT for liver tumors.

Purpose of the Study:

  • To review the current status and identify patient selection criteria for orthotopic liver transplantation in malignant primary liver tumors.
  • To discuss the potential of OLT for specific liver cancer types and metastatic neuroendocrine tumors.
  • To highlight the ongoing development of therapeutic strategies to improve outcomes and reduce recurrence after OLT.

Main Methods:

  • Review of recent advancements in patient selection for OLT in malignant liver tumors.
  • Analysis of survival data and recurrence rates for various primary liver malignancies treated with OLT.
  • Discussion of emerging therapeutic strategies aimed at minimizing post-transplant disease recurrence.

Main Results:

  • Patients with Union for International Cancer Control (UICC) stages I or II hepatocellular carcinoma, fibrolamellar hepatocellular carcinoma, or epithelioid hepatic hemangioendothelioma are identified as suitable candidates for OLT.
  • Selected patients with neuroendocrine tumors metastatic to the liver may achieve long-term palliation with OLT.
  • Therapeutic strategies are under development for advanced hepatocellular carcinoma and cholangiocarcinoma, but published survival rates remain suboptimal.

Conclusions:

  • Orthotopic liver transplantation is a viable option for carefully selected patients with specific malignant primary liver tumors.
  • Significant advancements in preventing disease recurrence are necessary for the wider application of OLT in managing malignant liver tumors.
  • Further research and development of innovative therapeutic strategies are essential to improve long-term survival for patients with advanced liver malignancies.

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