J Liver Cancer.  2015 Mar;15(1):4-10. 10.0000/jlc.2015.15.1.4.

Surgical Perspectives of Hepatocellular Carcinoma beyond the Barcelona Clinical Liver Cancer Guideline; Focusing on Liver Transplantation

• Yi NJ
• Lee KW
• Suh KS

• KMID: 2154068
• DOI: http://doi.org/10.0000/jlc.2015.15.1.4

Abstract

The management of hepatocellular carcinoma (HCC) is decided according to the evidence base recommendations generated by international societies especially by Barcelona clinical liver cancer (BCLC) guideline. However, the BCLC guideline based on studies of the Western countries, has not been well matched to real life cohort in Korea. In Western countries, a deceased donor liver transplantation has been well allocated to the HCC patients with preserved liver function. Patients with mild to moderate portal hypertension and certain BCLC B patients could be eligible for hepatic resection if a chance for 50% survival rate at 5 years is perceived. If liver transplantation (LT) is back up for liver resection in those patients as a salvage therapy, widening indication of liver resection could be much easily acceptable. On the other hands, new selection criteria of HCC beyond Milan criteria considering tumor biology, has been provided in the field of LT resulting in more than 50% survival rate at 5 years. Herein, surgical perspectives beyond the BCLC recommendation for LT for HCC would be reviewed in the respect of Korean surgeon's view in this article.

Keyword

Hepatocellular carcinoma; BCLC guideline; Liver transplantation

MeSH Terms

Biology
Carcinoma, Hepatocellular*
Cohort Studies
Hand
Humans
Hypertension, Portal
Korea
Liver Neoplasms*
Liver Transplantation*
Liver*
Patient Selection
Salvage Therapy
Survival Rate
Tissue Donors