Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000069.xml
Semin Liver Dis 2005; 25(2): 181-200
DOI: 10.1055/s-2005-871198
DOI: 10.1055/s-2005-871198
Resection and Liver Transplantation for Hepatocellular Carcinoma
Josep M. Llovet1 , 2 , Myron Schwartz2 , Vincenzo Mazzaferro3- 1Senior Researcher, BCLC Group, Liver Unit, Digestive Disease Institute, IDIBAPS, Hospital Clínic, University of Barcelona, Catalonia, Spain
- 2Division of Liver Diseases and Recanati Miller Transplantation Institute, Mount Sinai School of Medicine, New York, New York
- 3G.I. Surgery and Liver Transplantation Unit, National Cancer Institute, Milan, Italy
Further Information
Publication History
Publication Date:
25 May 2005 (online)
ABSTRACT
Surveillance programs in cirrhotic patients enable the detection of hepatocellular carcinoma (HCC) at early stages, when the tumor is amenable to curative treatments (60% of cases in Japan; 25 to 40% in Europe and the United States). Resection is the mainstay of treatment in noncirrhotic patients and in cirrhotics with well-preserved liver function. In modern series, a perioperative mortality ≤ 3% and 5-year survival rates above 50% are expected. Tumor recurrence complicates half of the cases at 3 years, but there is no unquestionable preventive treatment. Liver transplantation provides excellent outcomes applying the Milan criteria (single nodule ≤ 5 cm or two or three nodules ≤ 3 cm), with 5-year survival rates of 70% and low recurrence rates. Although expansion of selection criteria is appealing, it should be assessed in the setting of prospective well-designed studies. Intention-to-treat analysis has shown that wide extended indications lead to 25% 5-year survival rates. Living donor liver transplantation is having a minor impact in HCC management. Molecular markers are needed to better select the candidates for surgery.
KEYWORDS
Hepatocellular carcinoma - resection - liver transplantation - living donor liver transplantation - adjuvant treatments
REFERENCES
- 1 Parkin D M, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: GLOBOCAN 2000. Int J Cancer. 2001; 94 153-156
- 2 El-Serag H B, Mason A C. Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med. 1999; 340 745-750
- 3 Bosch F X, Ribes J, Diaz M, Cleries R. Primary liver cancer: worldwide incidence and trends. Gastroenterology. 2004; 127 S5-S16
- 4 Sangiovanni A, Del Ninno E, Fasani P et al.. Increased survival of cirrhotic patients with hepatocellular carcinoma detected during surveillance. Gastroenterology. 2004; 126 1005-1014
- 5 Llovet J M, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet. 2003; 362 1907-1917
- 6 Bruix J, Sherman M, Llovet J M et al.. Clinical management of hepatocellular carcinoma: conclusions of the Barcelona-2000 EASL conference. J Hepatol. 2001; 35 421-430
- 7 Llovet J M, Bustamante J, Castells A et al.. Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials. Hepatology. 1999; 29 62-67
- 8 Villa E, Moles A, Ferretti I et al.. Natural history of inoperable hepatocellular carcinoma: estrogen receptors’ status in the tumor is the strongest prognostic factor for survival. Hepatology. 2000; 32 233-238
- 9 Takayama T, Makuuchi S, Hirohashi S et al.. Early hepatocellular carcinoma as an entity with high rate of surgical cure. Hepatology. 1998; 28 1241-1246
- 10 Fong Y, Sun R L, Jarnagin W, Blumgart L H. An analysis of 412 cases of hepatocellular carcinoma at a Western center. Ann Surg. 1999; 229 790-799
- 11 Llovet J M, Fuster J, Bruix J. Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology. 1999; 30 1434-1440
- 12 Arii S, Yamaoka Y, Futagawa S et al.. Results of surgical and nonsurgical treatment for small-sized hepatocellular carcinomas: a retrospective and nationwide survey in Japan. Hepatology. 2000; 32 1224-1229
- 13 Zhou X D, Tang Z Y, Yang B H et al.. Experience of 1000 patients who underwent hepatectomy for small hepatocellular carcinoma. Cancer. 2001; 91 1479-1486
- 14 Poon R T, Fan S T, Lo C M et al.. Long-term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation. Ann Surg. 2002; 235 373-382
- 15 Wayne J D, Lauwers G Y, Ikai I et al.. Preoperative predictors of survival after resection of small hepatocellular carcinomas. Ann Surg. 2002; 235 722-731
- 16 Kianmanesh R, Regimbeau J M, Bekghiti J. Selective approach to major hepatic resection for hepatocellular carcinoma on chronic liver disease. Surg Oncol Clin N Am. 2003; 12 51-63
- 17 Ercolani G, Grazi G L, Ravaioli M et al.. Liver resection for hepatocellular carcinoma on cirrhosis. Ann Surg. 2003; 237 536-543
- 18 Ikai I, Arii S, Kojiro M et al.. Reevaluation of prognostic factors for survival after liver resection in patients with hepatocellular carcinoma in a Japanese nationwide survey. Cancer. 2004; 101 796-802
- 19 Mazzaferro V, Regalia E, Doci R et al.. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996; 334 693-699
- 20 Bismuth H, Majno P E, Adam R. Liver transplantation for hepatocellular carcinoma. Semin Liver Dis. 1999; 19 311-322
- 21 Jonas S, Bechstein W O, Steinmuller T et al.. Vascular invasion and histopathologic grading determine outcome after liver transplantation for hepatocellular carcinoma in cirrhosis. Hepatology. 2001; 33 1080-1086
- 22 Yao F Y, Ferrell L, Bass N M et al.. Liver transplantation for hepatocellular carcinoma: expansion of tumor size limits does not adversely impact survival. Hepatology. 2001; 33 1394-1403
- 23 Adam R, Azoulay D, Castaing D et al.. Liver resection as a bridge to transplantation for hepatocellular carcinoma on cirrhosis: a reasonable strategy?. Ann Surg. 2003; 238 508-519
- 24 Hemming A W, Nelson D R, Reed A I. Liver transplantation for hepatocellular carcinoma. Minerva Chir. 2002; 57 575-585
- 25 Shetty K, Timmins K, Brensinger C et al.. Liver transplantation for hepatocellular carcinoma validation of present selection criteria in predicting outcome. Liver Transpl. 2004; 10 911-918
- 26 Herrero J I, Sangro B, Quiroga J et al.. Influence of tumor characteristics on the outcome of liver transplantation among patients with liver cirrhosis and hepatocellular carcinoma. Liver Transpl. 2001; 7 631-636
- 27 Roayaie S, Frischer J, Emre S H et al.. Long-term results with multimodal adjuvant therapy and liver transplantation for the treatment of hepatocellular carcinomas larger than 5 cm. Ann Surg. 2002; 235 533-539
- 28 Marsh J W, Dvorchik I. Liver organ allocation for hepatocellular carcinoma: are we sure?. Liver Transpl. 2003; 9 693-696
- 29 Molmenti E, Klintmalm G. Liver transplantation in association with hepatocellular carcinoma: an update of the International Tumor Registry. Liver Transpl. 2002; 8 736-748
- 30 Cillo U, Vitale A, Bassanello M et al.. Liver transplantation for the treatment of moderately or well-differentiated hepatocellular carcinoma. Ann Surg. 2004; 239 150-159
-
31
National Cancer Institute website, U.S. National Institutes of Health .
http://www.cancer.gov
- 32 Kaihara S, Kiuchi T, Ueda M et al.. Living donor liver transplantation for hepatocellular carcinoma. Transplantation. 2003; 75 S37-S40
- 33 Gondolesi G, Roayaie S, Muñoz L et al.. Adult living donor liver transplantation for patients with hepatocellular carcinoma: extending UNOS priority criteria. Ann Surg. 2004; 239 142-149
- 34 Todo S, Furukawa H. Living donor liver transplantation for adult patients with hepatocellular carcinoma: experience in Japan. Ann Surg. 2004; 240 451-461
- 35 Llovet J M, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology. 2003; 37 429-442
- 36 Llovet J M, Real M I, Montaña X et al.. Arterial embolisation or chemoembolization versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomized controlled trial. Lancet. 2002; 359 1734-1739
- 37 Belghiti J, Hiramatsu K, Benoist S. Seven hundred forty-seven hepatectomies in the 1990s: an update to evaluate the actual risk of liver resection. J Am Coll Surg. 2000; 191 38-46
- 38 Bralet M P, Regimbeau J M, Pineau P et al.. Hepatocellular carcinoma occurring in nonfibrotic liver: epidemiologic and histopathologic analysis of 80 French cases. Hepatology. 2000; 32 200-204
- 39 Bismuth H, Majno P E. Hepatobiliary surgery. J Hepatol. 2000; 32(1 suppl) 208-224
- 40 Song T, Ip E, Fong Y. Hepatocellular carcinoma: current surgical management. Gastroenterology. 2004; 127 S248-S260
- 41 Marin-Hargreaves G, Azoulay D, Bismuth H. Hepatocellular carcinoma: surgical indications and results. Crit Rev Oncol Hematol. 2003; 47 13-27
- 42 Makuuchi M, Sano K. The surgical approach to HCC: our progress and results in Japan. Liver Transpl. 2004; 10 S46-S52
- 43 Torzilli G, Makuuchi M, Inoue K et al.. No-mortality liver resection for hepatocellular carcinoma in cirrhotic and noncirrhotic patients: is there a way? A prospective analysis of our approach. Arch Surg. 1999; 134 984-992
- 44 Fan S T, Lo C M, Liu C L et al.. Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths. Ann Surg. 1999; 229 322-330
-
45 Sobin LH, Wittekind C TNM Classification of Malignant Tumors. 5th ed. New York; John Wiley & Sons 1997
- 46 Liver (including intrahepatic bile ducts) .In: Green F, Page D, Fleming I, et al AJCC Cancer Staging Handbook. 6th ed. New York; Springer 2002: 131-144
- 47 Izumi R, Shimizu K, Ii T et al.. Prognostic factors of hepatocellular carcinoma in patients undergoing hepatic resection. Gastroenterology. 1994; 106 720-727
- 48a Llovet J M, Bruix J, Fuster J et al.. Liver transplantation for treatment of small hepatocellular carcinoma: the TNM classification does not have prognostic power. Hepatology. 1998; 27 1572-1577
- 48b Sala M, Forner A, Varela M, Bruix J. Prognostic prediction in patients with hepatocellular carcinoma. Semin Liver Dis. 2005; 25 171-180
- 49 Llovet J M, Bru C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999; 19 329-338
- 50 Befeler A S, Di Bisceglie A M. Hepatocellular carcinoma: diagnosis and treatment. Gastroenterology. 2002; 122 1609-1619
- 51 Marrero J, Fontana R, Barrat A et al.. Prognosis of hepatocellular carcinoma: comparison of seven staging systems in an American cohort. Hepatology. 2005; , In press
- 52 Vauthey J, Lauwers G, Esnaola N et al.. Simplified staging for hepatocellular carcinoma. J Clin Oncol. 2002; 20 1527-1536
- 53 Poon R, Fan S. Evaluation of the new AJCC/UICC staging system for hepatocellular carcinoma after hepatic resection in Chinese patients. Surg Oncol Clin N Am. 2003; 12 35-50
- 54 Makuuchi M, Hasegawa H, Yamazaki S. Indication of hepatectomy in patients with hepatocellular carcinoma and cirrhosis. Shindan to Chiryo (in Japanese). 1986; 74 1225-1230
- 55 Miyagawa S, Mackuuchi M, Kawasaki S et al.. Criteria for safe hepatic resection. Am J Surg. 1995; 169 589-594
- 56 Poon R, Fan S T. Hepatectomy for hepatocellular carcinoma: patient selection and postoperative outcome. Liver Transpl. 2004; 10 S39-S45
- 57 Bruix J, Castells A, Bosch J et al.. Surgical resection of hepatocellular carcinoma in cirrhotic patients: prognostic value of preoperative portal pressure. Gastroenterology. 1996; 111 1018-1022
- 58 Murakami T, Mochizuki K, Nakamura H. Imaging evaluation of the cirrhotic liver. Semin Liver Dis. 2001; 21 213-224
- 59 Rizzi P M, Kane P A, Ryder S D et al.. Accuracy of radiology in detection of hepatocellular carcinoma before liver transplantation. Gastroenterology. 1994; 107 1425-1429
- 60 De Carlis L, Giacomoni A, Pirotta V et al.. Surgical treatment of hepatocellular cancer in the era of hepatic transplantation. J Am Coll Surg. 2003; 196 887-897
- 61 Burrel M, Llovet J M, Ayuso C et al.. MRI angiography is superior to helical CT for detection of HCC prior to liver transplantation: an explant correlation. Hepatology. 2003; 38 1034-1042
- 62 Torzilli G, Olivari N, Moroni E et al.. Contrast-enhanced intraoperative ultrasonography in surgery for hepatocellular carcinoma in cirrhosis. Liver Transpl. 2004; 10 S34-S38
- 63 Llovet J M, Wurmbach E. Gene expression profile in hepatocellular carcinoma: not yet there. J Hepatol. 2004; 41 336-339
- 64 Makuuchi M, Belghiti J B, Belli G et al.. IHPBA concordant classification of primary liver cancer: working group report. J Hepatobiliary Pancreat Surg. 2003; 10 26-30
- 65 Kojiro M. Focus on dysplastic nodules and early hepatocellular carcinoma: an eastern point of view. Liver Transpl. 2004; 10 S3-S8
- 66 Sakamoto M, Hirohashi S. Natural history and prognosis of adenomatous hyperplasia and early hepatocellular carcinoma: multi-institutional analysis of 53 nodules followed up for more than 6 months and 141 patients with single early hepatocellular carcinoma treated by surgical resection or percutaneous ethanol injection. Jpn J Clin Oncol. 1998; 28 604-608
- 67 Lee J, Chu I, Heo J et al.. Classification and prediction of survival in hepatocellular carcinoma by gene expression profiling. Hepatology. 2004; 40 667-676
- 68 Belghiti J, Panis Y, Farges O et al.. Intrahepatic recurrence after resection of hepatocellular carcinoma complicating cirrhosis. Ann Surg. 1991; 214 114-117
- 69 Okada S, Shimada K, Yamamoto J et al.. Predictive factors for postoperative recurrence of hepatocellular carcinoma. Gastroenterology. 1994; 106 1618-1624
- 70 Adachi E, Maeda T, Matsumata T et al.. Risk factors for intrahepatic recurrence in human small hepatocellular carcinoma. Gastroenterology. 1995; 108 768-775
- 71 Kumada T, Nakano S, Takeda I et al.. Patterns of recurrence after initial treatment in patients with small hepatocellular carcinoma. Hepatology. 1997; 25 87-92
- 72 Imamura H, Matsuyama Y, Tanaka E et al.. Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol. 2003; 38 200-207
- 73 Iizuka N, Oka M, Yamada-Okabe H et al.. Oligonucleotide microarray for prediction of early intrahepatic recurrence of hepatocellular carcinoma after curative resection. Lancet. 2003; 361 923-929
- 74 Chen Y, Yeh S H, Chen J T et al.. Chromosomal changes and clonality relationship between primary and recurrent hepatocellular carcinoma. Gastroenterology. 2000; 119 431-440
- 75 Finkelstein S D, Marsh W, Demetris A J et al.. Microdissection-based allelotyping discriminates de novo tumor from intrahepatic spread in hepatocellular carcinoma. Hepatology. 2003; 37 871-879
- 76 Ng I, Guan X, Poon R et al.. Determination of the molecular relationship between multiple tumor nodules in hepatocellular carcinoma differentiates multicentric origin from intrahepatic metastasis. J Pathol. 2003; 199 345-353
- 77 Muto Y, Moriwaki H, Ninomiya M, Adachi S, Saito A, Takasaki K T. Prevention of second primary tumors by an acyclic retinoid, polyprenoic acid, in patients with hepatocellular carcinoma. N Engl J Med. 1996; 334 1561-1567
- 78 Schwartz J D, Schwartz M, Mandeli J, Sung M. Neoadjuvant and adjuvant therapy for resectable hepatocellular carcinoma: review of the randomised clinical trials. Lancet Oncol. 2002; 3 593-603
- 79 Wu C C, Oho Y Z, Lin W et al.. Preoperative transcatheter arterial chemoembolization for resectable large hepatocellular carcinoma: a reappraisal. Br J Surg. 1995; 82 122-126
- 80 Yamasaki S, Hasegawa H, Kinoshita H et al.. A prospective randomized trial of preventive effect of pre-operative transcatheter arterial embolization against recurrence of hepatocellular carcinoma. Jpn J Cancer Res. 1996; 87 206-211
- 81 Izumi R, Shimizu S, Iyobe T et al.. Postoperative adjuvant hepatic arterial infusion of lipiodol containing anticancer drugs in patients with hepatocellular carcinoma. Hepatology. 1994; 20 295-301
- 82 Li J Q, Zhang Y K, Zhang W Z et al.. Randomized study of chemoembolization as an adjuvant therapy for primary liver carcinoma after hepatectomy. J Cancer Res Clin Oncol. 1995; 121 364-366
- 83 Lai E C, Lo C M, Fan S T et al.. Postoperative adjuvant chemotherapy after curative resection of hepatocellular carcinoma. Arch Surg. 1998; 133 183-188
- 84 Ueno S, Tanabe G, Yoshida K et al.. Postoperative prediction and strategy for metastatic recurrent hepatocellular carcinoma according to histologic activity of hepatitis. Cancer. 1999; 86 248-254
- 85 Khono H, Nagasue H, Hayashi H et al.. Postoperative adjuvant chemotherapy after radical hepatic resection for hepatocellular carcinoma (HCC). Hepatogastroenterology. 1996; 43 1405-1409
- 86 Lau W Y, Leung T W, Ho S K et al.. Adjuvant intra-arterial iodine-131-labelled lipiodol for resectable hepatocellular carcinoma: a prospective randomised trial. Lancet. 1999; 353 797-801
- 87 Yamamoto M, Arii S, Sughara K et al.. Adjuvant oral chemotherapy after curative resection of hepatocellular carcinoma. Br J Surg. 1996; 83 336-340
- 88 Ono T, Nagasue N, Kohno H et al.. Adjuvant chemotherapy with epirubicin and carmofur after radical resection of hepatocellular carcinoma: a prospective randomized study. Semin Oncol. 1997; 24(suppl 6) S6-18
- 89 Takayama T, Sekine T, Makuuchi M et al.. Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomised trial. Lancet. 2000; 356 802-807
- 90 Ikeda K, Arase Y, Saitoh S et al.. Interferon beta prevents recurrence of hepatocellular carcinoma after complete resection or ablation of the primary tumor: a prospective randomized study of hepatitis C virus-related liver cancer. Hepatology. 2000; 32 228-232
- 91 Kubo S, Nishiguchi S, Hirohashi K et al.. Effects of long-term postoperative interferon-alpha therapy on intrahepatic recurrence after resection of hepatitis C virus-related hepatocellular carcinoma. Ann Intern Med. 2001; 134 963-967
- 92 Shiratobi Y, Shiina S, Teratani T et al.. Interferon therapy after tumor ablation improves prognosis in patients with hepatocellular carcinoma associated with hepatitis C virus. Ann Intern Med. 2003; 138 299-306
- 93 Lin S M, Lin C J, Hsu C W et al.. Prospective randomized controlled study of interferon-alpha in preventing hepatocellular carcinoma recurrence after medical ablation therapy for primary tumors. Cancer. 2004; 100 376-382
- 94 Boucher E, Corbinais S, Rolland Y. Adjuvant intra-arterial injection of iodine-131-labeled lipiodol after resection of hepatocellular carcinoma. Hepatology. 2003; 38 1237-1241
- 95 Majno P E, Sarasin F P, Mentha G. Primary liver resection and salvage transplantation or primary liver transplantation in patients with single, small hepatocellular carcinoma and preserved liver function: an outcome-oriented decision analysis. Hepatology. 2000; 31 899-906
- 96 Llovet J M, Bruix J, Gores G. Surgical resection vs transplantation for early hepatocellular carcinoma: clues for the best strategy. Hepatology. 2000; 31 1019-1021
- 97 Belghiti J, Cortes A, Abdalla E et al.. Resection prior to liver transplantation for hepatocellular carcinoma. Ann Surg. 2003; 238 885-893
- 98 Sala M, Fuster J, Llovet J M et al.. High pathological risk of recurrence after surgical resection for HCC. An indication for liver transplantation. Liver Transpl. 2004; 10 1294-1300
- 99 Esquivel C O, Iwatsuki S, Gordon R D, Starzl T E. Transplantation for primary liver cancer. In: Wanebo HJ Hepatic and Biliary Cancer. New York; Marcel Dekker 1987: 484
- 100 Lotze M T, Wanebo H J. Current and future research directions in management of hepatic cancer. In: Wanebo HJ Hepatic and Biliary Cancer. New York; Marcel Dekker 1987: 512
- 101 Ringe B, Pichlmayr R, Wittekind C, Tusch G. Surgical treatment of hepatocellular carcinoma: experience with liver resection and transplantation in 198 patients. World J Surg. 1991; 15 270-285
- 102 Iwatsuki S, Starzl T E, Sheahan D G et al.. Hepatic resection versus transplantation for hepatocellular carcinoma. Ann Surg. 1991; 214 221-228
- 103 Iwatsuki S, Gordon R D, Shaw Jr B W et al.. Role of liver transplantation in cancer therapy. Ann Surg. 1985; 202 401-407
- 104 Bismuth H, Chiche L, Adam R, Castaing D, Diamond T, Dennison A. Liver resection versus transplantation for hepatocellular carcinoma in cirrhosis. Ann Surg. 1993; 218 145-151
- 105 Bruix J, Llovet J M. Prognostic prediction and treatment strategy in hepatocellular carcinoma. Hepatology. 2002; 35 519-524
- 106 Roayaie S, Ben-Haim M, Fishbein T M et al.. Comparison of surgical outcomes for hepatocellular carcinoma in patients with hepatitis B versus hepatitis C: a Western experience. Ann Surg Oncol. 2000; 7 764-770
- 107 Llovet J M, Sala M, Fuster J et al.. Predictors of drop-out and survival of patients with hepatocellular carcinoma candidates for liver transplantation. Hepatology. 2003; 38 763A
- 108 Yao F, Bass N, Nikolai B et al.. A follow-up analysis of the pattern and predictors of dropout from the waiting list for liver transplantation in patients with hepatocellular carcinoma: implications for the current organ allocation policy. Liver Transpl. 2003; 9 684-692
- 109 Maddala Y K, Stadheim L, Andrews J C et al.. Drop-out rates of patients with hepatocellular cancer listed for liver transplantation: outcome with chemoembolization. Liver Transpl. 2004; 10 449-455
- 110 Bruix J, Fuster J, Llovet J M. Liver transplantation for hepatocellular carcinoma: Foucault pendulum vs evidence-based decision. Liver Transpl. 2003; 9 700-702
- 111 Marsh J W, Geller D, Finkelstein S et al.. Role of liver transplantation for hepatobiliary malignant disorders. Lancet Oncol. 2004; 5 480-488
- 112 Schwartz M. Liver transplantation for hepatocellular carcinoma. Gastroenterology. 2004; 127 S268-S276
- 113 Stone M J, Klintmalm G B, Polter D et al.. Neoadjuvant chemotherapy and liver transplantation for hepatocellular carcinoma: a pilot study in 20 patients. Gastroenterology. 1993; 104 196-202
- 114 Olthoff K M, Rosove M H, Shackleton C R et al.. Adjuvant chemotherapy improves survival after liver transplantation for hepatocellular carcinoma. Ann Surg. 1995; 221 734-741
- 115 Majno P E, Adam R, Bismuth H et al.. Influence of preoperative transarterial lipiodol chemoembolization on resection and transplantation for hepatocellular carcinoma in patients with cirrhosis. Ann Surg. 1997; 226 688-701
- 116 Oldhafer K J, Chavan A, Fruhauf N R et al.. Arterial chemoembolization before liver transplantation in patients with hepatocellular carcinoma: marked tumor necrosis, but no survival benefit?. J Hepatol. 1998; 29 953-959
- 117 Graziadei I W, Sandmueller H, Waldenberger P et al.. Chemoembolization followed by liver transplantation for hepatocellular carcinoma impedes tumor progression while on the waiting list and leads to excellent outcome. Liver Transpl. 2003; 9 557-563
- 118 Mazzaferro V, Battiston C, Perrone S. Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation: a prospective study. Ann Surg. 2004; 240 900-909
- 119 Lu D S, Yu N C, Raman S S et al.. Radiofrequency ablation of hepatocellular carcinoma: treatment success as defined by histologic examination of the explanted liver. Radiology. 2005; 234 954-960
- 120 Llovet J M, Mas X, Aponte J et al.. Cost-effectiveness of adjuvant therapy for hepatocellular carcinoma before liver transplantation. Gut. 2002; 50 123-128
- 121 Roayaie S, Llovet J M. Extended indications for liver transplantation in hepatocellular carcinoma. Clin Liver Dis. 2005; 9 315-328
- 122 Miller C M, Gondolesi G E, Florman S et al.. One hundred nine living donor liver transplants in adults and children: a single-center experience. Ann Surg. 2001; 234 301-312
- 123 Marcos A. Right lobe living donor liver transplantation: a review. Liver Transpl. 2000; 6 3-20
- 124 Trotter J, Wachs M, Everson G, Kam I. Adult-to-adult transplantation of the right hepatic lobe from living donor. N Engl J Med. 2002; 346 1074-1082
- 125 Sugawara Y, Makuuchi M, Takayama T. Safe donor hepatectomy for living related liver transplantation. Liver Transpl. 2002; 8 58-62
- 126 Ben-Haim M, Emre S, Fishbein T M et al.. Critical graft size in adult-to-adult living donor liver transplantation: impact of the recipient's disease. Liver Transpl. 2001; 7 948-953
- 127 Sarasin F, Majno P, Llovet J M, Mentha J, Bruix J, Hadengue A. Liver donor liver transplantation for early hepatocellular carcinoma: a cost-effectiveness perspective. Hepatology. 2001; 33 1073-1079
- 128 Garcia-Retortillo M, Forns X, Llovet J M et al.. Hepatitis C recurrence is more severe after living donor transplantation compared to cadaveric liver transplantation. Hepatology. 2004; 40 699-707
- 129 Bozorgzadeh A, Jain A, Ryan C et al.. Impact of hepatitis C viral infection in primary cadaveric liver allograft versus primary living-donor allograft in 100 consecutive liver transplant recipients receiving tacrolimus. Transplantation. 2004; 77 1066-1107
- 130 Gaglio P J, Malireddy S, Levitt B S. Increased risk of cholestatic hepatitis C in recipients of grafts from living versus cadaveric liver donors. Liver Transpl. 2003; 9 1028-1035
- 131 Forns Garcia-Retortillo M, Forns X. Prevention and treatment of hepatitis C virus recurrence after liver transplantation. J Hepatol. 2004; 41 2-10
- 132 Starzl T E, Marchioro T L, Faris T D. Liver transplantation. Ann Intern Med. 1966; 64 473-477
Josep M LlovetM.D.
Division of Liver Diseases, RM Transplantation Institute, Mount Sinai School of Medicine
1425 Madison Ave, 11F-70, Box:1104
New York, NY10029
Email: Josep.Llovet@mssm.edu