• World J Gastroentero · Jul 2008

    Review

    Hepatocellular carcinoma: defining the place of surgery in an era of organ shortage.

    • Adam Bartlett and Nigel Heaton.
    • Institute of Liver Studies, Kings College School of Medicine at Kings College Hospital, Denmark Hill, London SE5 9RS, UK.
    • World J Gastroentero. 2008 Jul 28;14(28):4445-53.

    AbstractLiver resection (LR) and transplantation offer the only potential chance of cure for patients with hepatocellular carcinoma (HCC). Historically, all patients were treated by hepatic resection. With the advent of liver transplantation (LT) patients with HCC were preferentially placed on the waiting list for LT. However, early experience with LT was associated with a high rate of tumour recurrence and poor long-term survival. The increasing scarcity of donor livers resulted in restrictions being placed on tumour size, and an improvement in patient survival. To date there have been no randomised clinical trials comparing LR to LT. We review the evidence supporting LR and/or LT for HCC and discuss the role of neoadjuvant therapy. The decision of whether to resect or transplant remains debatable and is often determined by centre experience, availability of LT and donor organs.

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