Role of Liver Transplantation in the Treatment of Unresectable Liver Cancer
Overview
Authors
Affiliations
Resection remains the treatment of choice in liver cancer. In order to avoid liver transplantation in conventionally unresectable tumors ex-situ ("bench" procedure), in-situ and ante-situm resection technique should be preferred whenever feasible. Despite the deficiency of donor organs, a single center experience with 198 patients reveals that liver transplantation continues its role as a therapeutic option for selected patients. At present "favorable" indications for transplantation are International Union against Cancer (UICC) - stage II hepatocellular carcinoma as well as the subtype fibrolamellar carcinoma, uncommon tumors such as epitheloid hemangioendothelioma, hepatoblastoma, and liver metastases from neuroendocrine tumors. Due to unsatisfying results, intrahepatic bile duct-, stage III and IV hepatocellular carcinoma, hemangiosarcoma, and liver metastases from nonendocrine primaries should be excluded from liver transplantation alone. For these advanced tumors, especially in cases of extrahepatic involvement, a combination of liver transplantation and multivisceral resection has been proven feasible. However, a significant improvement in patient survival may only be expected only by currently investigated multimodality treatment protocols which will require further randomized studies.
Cholangiocarcinoma: The Current Status of Surgical Options including Liver Transplantation.
Esmail A, Badheeb M, Alnahar B, Almiqlash B, Sakr Y, Khasawneh B Cancers (Basel). 2024; 16(11).
PMID: 38893067 PMC: 11171350. DOI: 10.3390/cancers16111946.
New Insights in the Setting of Transplant Oncology.
Quaresima S, Melandro F, Giovanardi F, Shah K, De Peppo V, Mennini G Medicina (Kaunas). 2023; 59(3).
PMID: 36984569 PMC: 10058845. DOI: 10.3390/medicina59030568.
Abdelrahim M, Al-Rawi H, Esmail A, Xu J, Umoru G, Ibnshamsah F Curr Oncol. 2022; 29(5):3585-3594.
PMID: 35621680 PMC: 9139862. DOI: 10.3390/curroncol29050290.
Treatment of Intrahepatic Cholangiocarcinoma-A Multidisciplinary Approach.
Krenzien F, Nevermann N, Krombholz A, Benzing C, Haber P, Fehrenbach U Cancers (Basel). 2022; 14(2).
PMID: 35053523 PMC: 8773654. DOI: 10.3390/cancers14020362.
Current Surgical Management of Peri-Hilar and Intra-Hepatic Cholangiocarcinoma.
Lauterio A, De Carlis R, Centonze L, Buscemi V, Incarbone N, Vella I Cancers (Basel). 2021; 13(15).
PMID: 34359560 PMC: 8345178. DOI: 10.3390/cancers13153657.