What is liver cancer liver transplantation

By | December 3, 2011

Liver transplantation in recent years, the application of more and more widely in the spot, liver cancer experts such as liver transplantation, especially for the treatment of small hepatocellular carcinoma associated with cirrhosis, better effect, than radical resection. Liver transplantation is not only due to removal of the liver, and the removal of the multicentric occurrence of soil eleven cirrhosis. Bismuth 120 cases of primary liver cancer in patients with liver cirrhosis and liver transplantation were performed for the prognosis of liver resection study, two groups of 3-year overall survival rate was similar (47% vs 50%), single or two nodules (diameter <3cm) better efficacy of small hepatocellular carcinoma (83% vs 41%); but the survival rates of transplants per group was better than resection group (46% vs 27%), small liver cancer is more difference between the two groups significant (83% vs 18%). Mazzaferro reported 48 cases of hepatocellular carcinoma with cirrhosis, liver transplantation surgery mortality rate was 17%, 4-year survival rate was 75% and the recurrence rate of 8%. 5-year survival rate after liver transplantation is often associated with tumor staging, Iwatsuki I reported on, and E of the 5-year survival rates were 75%, of 48%, while a period of 0%, recurrence rates were 0 %, 5.3%, 17.4% and 67.8%. To this end, TNM staging for liver transplantation and part I of stage patients, the tumor is limited to one side, and vascular invasion by element.
Liver transplantation is also effective on the biological characteristics of the tumor, Penn reported fibrolamellar hepatocellular carcinoma (FL-HCC) 5-year survival rate was 55%, and liver vascular endothelial sarcoma at 27.5 months, all died. Biological characteristics and thus should choose a better liver, such as FL-HCC, hilar cholangiocarcinoma (Klatskin tumor), AFP-negative cancer, and so, in preference to vascular endothelial sarcoma of the liver, metastatic liver cancer patients for liver transplantation . HCC with distant metastasis and (or) the formation of portal vein invasion were contraindications for the surgery. Preoperative, intraoperative and postoperative combined with chemotherapy before surgery may be possible to kill the small disseminated lesions and reduce tumor recurrence. Also reported in the Na and liver transplantation of hepatocellular carcinoma with adriamycin (ADM) neoadjuvant chemotherapy, 1-year survival rate of up to 53%. In short, the ideal case selection is to improve the survival rate of patients with hepatocellular carcinoma after liver transplantation key. Comprehensive and systematic preoperative examination should be performed on the patient's condition, the course to give a definitive assessment, the body is not left behind after surgery for any tumor cells. Generally believed that tumor diameter <5cm, single nodule, local lymph node enlargement, no vascular invasion, tumor pseudocapsule, non-invasive growth, a good degree of pathological differentiation, tissue negative margins, mild or no merger cirrhosis of the liver, there is no combined hepatitis B virus infection, good efficacy in these patients after liver transplantation.
Liver transplantation has experienced 30 years of practice and exploration, has become the treatment of liver cancer in some effective way. But in China, due to donor source, funding, efficacy and HBV infection in recent years is still difficult to promote, present only in end-stage liver cirrhosis is the main indication for liver transplantation.

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