Hepatocellular Carcinoma in Transplantable Child-Pugh A Cirrhotics: Should Cost Affect Resection vs Transplantation?

  title={Hepatocellular Carcinoma in Transplantable Child-Pugh A Cirrhotics: Should Cost Affect Resection vs Transplantation?},
  author={T. Michelakos and Dimitrios Xourafas and Motaz Qadan and Rafael V. Pieretti-Vanmarcke and Lei Cai and Madhukar S. Patel and Joel T Adler and Fermin Fontan and Usama Basit and Parsia A. Vagefi and Nahel Elias and Kenneth K Tanabe and David H. Berger and Heidi Yeh and James F. Markmann and David C. Chang and Cristina R. Ferrone},
  journal={Journal of Gastrointestinal Surgery},
BackgroundThere is no consensus regarding the optimal surgical treatment for transplantable hepatocellular carcinoma (HCC) patients with well-compensated cirrhosis. Our aim was to compare outcomes between Child-Pugh A (CPA) cirrhotics who underwent liver resection or transplantation for HCC.MethodsClinicopathologic data were retrospectively collected for all surgically treated HCC patients between 7/1992 and 12/2015. Disease-free survival (DFS) and overall survival (OS) were calculated from the… 

Poorly differentiated hepatocellular carcinoma: resection is equivalent to transplantation in patients with low liver fibrosis.

  • O. SalehiE. Vega C. Conrad
  • Medicine
    HPB : the official journal of the International Hepato Pancreato Biliary Association
  • 2021

The Treatment Effect of Liver Transplantation versus Liver Resection for HCC: A Review and Future Perspectives

A comprehensive review of research articles comparing these two treatments with a focus on factors accounting for selection bias is presented and a new research design is suggested that uses a treatment guideline to help ensure that the groups are more comparable.

Conditional Survival in Resected Pancreatic Ductal Adenocarcinoma Patients Treated with Total Neoadjuvant Therapy

For resected TNT-treated BR/LA PDAC patients, the probability of surviving an additional length of time increases as a function of survival already accrued and dynamic survival estimates may allow personalized follow-up and counseling.

Liver resection versus liver transplantation for hepatocellular carcinoma within Milan criteria: a meta-analysis of 18,421 patients.

Mortality after LR for HCC is nearly 50% higher compared to LT and the risk of recurrence after LR is threefold that of LT, and survival between LR and LT were similar in uninodular disease.



Liver Resection for Transplantable Hepatocellular Carcinoma: Long-Term Survival and Role of Secondary Liver Transplantation

LR for small solitary HCC in compensated cirrhosis yields an overall survival rate comparable to upfront LT, and close imaging monitoring after resection allows salvage LT in 61% of patients with recurrence on intention to treat analysis.

Is Resection or Transplantation the ideal Treatment in Patients with Hepatocellular Carcinoma in Cirrhosis if Both Are Possible? A Systematic Review and Metaanalysis

A low quality of evidence data suggests resectable HCC should primarily be resected as good alternative to liver transplantation in patients in whom both seem feasible.

Liver transplantation for hepatocellular carcinoma: Expansion of the tumor size limits does not adversely impact survival

The current criteria for OLT based on tumor size may be modestly expanded while still preserving excellent survival after OLT, and only pT4 stage and total tumor diameter remained statistically significant in multivariate analysis.

Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis.

Liver transplantation is an effective treatment for small, unresectable hepatocellular carcinomas in patients with cirrhosis and after four years, the actuarial survival rate was 75 percent and the rate of recurrence-free survival was 83 percent.

Changes and Results of Surgical Strategies for Hepatocellular Carcinoma: Results of a 15-year Study on 452 Consecutive Patients

Although the tumor-free survival rates were similar between the two groups, the survival rate in group B was significantly better, and recent advances in imaging modalities used during follow-up for the early detection of recurrence and for planning multimodality treatment have contributed to increasing the survival rates.

No-mortality liver resection for hepatocellular carcinoma in cirrhotic and noncirrhotic patients: is there a way? A prospective analysis of our approach.

With high resectability, low morbidity, and no mortality, the policy represents a solution to the drawbacks of surgical resection for treatment of HCCs, especially in patients with associated liver cirrhosis.

Liver Resection for Hepatocellular Carcinoma Results of 229 Consecutive Patients During 11 Years

Multidisciplinary approach with liver resection, postoperative chemotherapy, and liver transplantation will be a realistic direction for the surgical treatment of HCC in future.

Operative Blood Loss Independently Predicts Recurrence and Survival After Resection of Hepatocellular Carcinoma

The magnitude of EBL during HCC resection is related to biologic characteristics of the tumor as well as the extent of surgery, and is an independent prognostic factor for tumor recurrence and death.

Surgical resection of hepatocellular carcinoma. Post‐operative outcome and long‐term results in Europe: An overview

A multicenter retrospective review of 1467 patients treated by liver resection (LR) for hepatocellular carcinoma (HCC) in Europe over a 13‐year period showed a mean mortality rate of 10.6%, which was