Surgery, Gastroenterology and Oncology
Vol. 26, Nr. 1, Mar 2021
Liver Transplantation and Surgery in the Management of Hepatocellular Carcinoma
Massimo Malagó, Dimitri Aristotle Raptis, Charles J. Imber, Giovanni Dalla Serra, Oskar Kornasiewicz
REVIEW, Mar 2021
Article DOI: 10.21614/sgo-26-320
Hepatocellular carcinoma (HCC) is the second cause of cancer–related deaths worldwide constitutes a major global health problem. Although our understanding of the molecular pathogenesis of hepatocellular HCC has improved, detected driver mutations are not yet sufficiently reliable therapeutic targets.
The modern management of HCC is conceived only within multidisciplinary schemes. Current systemic therapies are not curative and surgical treatments remain the only potential curative treatments for selected patients with early stage HCC.
The role of parenchyma sparing liver resection for appropriately selected patients may vary in different environments according to organ availability,and liver resection remains a reliable curative method for HCC.
Meta-analyses have shown that clinical outcomes of surgical resection are superior to ablative treatments in early stage HCC. Liver transplantation is still the standard treatment for patients with early stage HCC. Lately the Milan Criteria are considered too restrictive, still recognizing that the extension of transplantation criteria beyond Milano criteria increases the risk of HCC recurrence.
Resection, ablation, transarterial embolization and trans-arterial radiation are commonly applied to bridge patients to transplant. Despite enormous advances in the therapy of HCC treatments at present, there are currently no genuine breakthroughs for patients with HCC.
The Clinical Trials Planning Meeting (CTPM) in HCC convened by the American Society of Clinical Oncology identified the key knowledge gaps in HCC and define clinical research priorities. Major improvements in survival provided by multimodal treatments witnessed in other cancers are not yet available for HCC because effective systemic treatment modalities for HCC are still lacking.
Integration of bio-genetic tumor information into current tested treatment schemes and truly multimodal surgery-based treatment schemes will enable the recruitment of less selected patients in larger numbers to curative treatments.

Full Text Sources: Download pdf
Abstract:   Abstract EN
Views: 312


Video Abstracts


Open Access Fee

Members of the IASGO will not pay open access fee. Non-members of IASGO will pay publishing fee of €150. Publishing fee, which will cover the DOI, plagiarism check, the editing work.


Journal Subscriptions

Current Issue

Mar 2021

Supplements

Instructions for authors
Online submission
Contact
Print ISSN: 2559 - 723X

ISSN-L: 2559 - 723X

ISSN online: 2601 - 1700

Surgery, Gastroenterology and Oncology is indexed in Scopus, CrossRef (DOI: 10.21614/sgo)



Meetings and Courses in 2021
Meetings and Courses in 2020
Meetings and Courses in 2019
Verona expert meeting 2019
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.