0000000000134023
AUTHOR
M. Hoppe-lotichius
Liver transplantation for hepatocellular carcinoma--is there a risk of recurrence caused by intraoperative blood salvage autotransfusion?
<i>Background/Aims:</i> The use of intraoperative blood salvage autotransfusion (IBSA) during surgical approaches may contribute to tumour cell dissemination. Therefore, IBSA should be avoided in cases of malignancy. However, the risks of IBSA might be acceptable in liver transplantation (LT) for selected small hepatocellular carcinoma (HCC). <i>Methods:</i> In total, 136 recipients of LT with histologically proven HCC in the explanted liver were included in this analysis. With regard to tumour recurrence, 40 patients receiving IBSA despite HCC (IBSA group) were compared to 96 patients without IBSA (non-IBSA group). <i>Results:</i> Milan criteria as asses…
Transarterial Chemoembolization Before Liver Transplantation in 60 Patients With Hepatocellular Carcinoma
Tumor recurrence is a major problem after orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC). In 60 patients OLT was performed for HCC after pretreatment by repeated transarterial chemoembolization (TACE). Forty-four recipients exceeded the Milan criteria. Recurrence-free 5-year survival was 65.2% and 5-year freedom from recurrence was 73.2%. During the waiting time, 14 patients experienced minimal change, which did not fulfill the definition of tumor progression according to official oncological criteria. Five-year freedom from recurrence among patients with stable compared with progressive disease was 93.3% versus 28.1%, respectively (P = .0001). A stri…
Surgical therapy of liver cancer: resection and transplantation
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and is estimated to cause approximately half a million deaths per year. Most tumours (80%) develop in cirrhotic livers caused by viral hepatitis C or B and alcoholic liver disease. In the natural course survival depends on the stage of the disease. At an early stage 3-year survival is 65% without treatment, in the intermediate stage between 10% and 50% of patients are reported to be alive after 2 years, and in the final stage median survival only rarely exceeds 6 months. Surgical treatment is capable of doubling survival. The results of local ablative treatment in early carcinoma are very similar to surgical treatment1…