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Colegio de Medicina Interna de México.

2006, Number 6

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Med Int Mex 2006; 22 (6)

Liver transplantation function in hepatocellular carcinoma

Bourlon de los RMT, Bourlon CR, Gómez SMÀ, Coronel AO

Language: Spanish
References: 34
Page: 508-513
PDF size: 208.80 Kb.


ABSTRACT

Hepatocellular carcinoma is the fifth most common malignancy in the world, responsible of 500,000 deaths globally every year. Although hepatocellular carcinoma is a slowing growing tumor, it is identified clinically at an advanced stage and usually together with cirrhosis. For treatment with a curative intent, the gold standard remains surgical resection, by either partial hepatectomy or total hepatectomy followed by liver transplantation. Resectability and choice of procedure depends on many factors, including liver function, absence of extrahepatic metastases, size of residual liver, availability of resources including liver graft, and expertise of the surgical team. Patients without cirrhosis can tolerate extensive resections, and partial hepatectomy should be considered first. Liver transplantation has been successful in treating limited-stage hepatocellular carcinoma. Liver transplant is the only treatment that simultaneously cures both, the tumor and the underlying liver disease/cirrhosis. However a minority of patients with hepatocellular carcinoma qualifies for transplantation. Patients with 1 hepatocellular carcinoma nodule ≤5 cm in diameter, or 2 to 3 nodules ≤3 cm meet the criteria for transplantation (Milan criteria); nevertheless, dropout from the waiting list is common. Expanding the selection criteria results in more patients being cured at the expense of higher incidence of recurrence. Recently radiofrequency ablation, chemoembolization, and cryotherapy might be indicated to limit tumor progression for patients on waiting lists.


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  34. A2ALL .




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