Liver transplantation for hepatocellular carcinoma (HCC) in patients with cirrhosis
is a radical treatment of the tumor and associated precancerous state. It is potentially
curative in a proportion of patients. The outcomes of early studies of liver transplantation
in this indication were initially unfavorable. Selection of transplant candidates
at an early stage, in the absence of extrahepatic spread, gives better survival than
surgical resection and alternative nonsurgical treatments. Transarterial chemoembolization
can be used for preoperative control of the disease. Adjuvant chemotherapy may be
indicated in the postoperative period for the prevention of recurrence in patients
with histologic features of invasiveness in the surgical specimen. Liver transplantation
as the treatment of choice for early HCC in screening programs in cirrhotic patients
may become limited by graft availability as the numbers of hepatitis C-related cases
increase. Resection may be indicated if the waiting time is likely to be long.
chemoembolization - hepatectomy - hepatocellular carcinoma - liver cirrhosis - liver
transplantation - patient selection - survival analysis