Hepatocellular cancer and liver transplantation: necessity to go from chaos to order

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Abstract

The care for liver-diseased patients presenting with hepatocellular cancer (HCC) is changing rapidly. Many treatment possibilities and caregivers belonging to a multitude of specialities troubled the therapeutic algorithm of the liver cancer patients. HCC in both normal and diseased livers has to be considered firstly as a surgical disease. The possibilities of surgery, including liver resections, as well as liver transplantation, have been underestimated and even been minimalized mainly as a consequence of many studies promoting in an unlimited way all different kinds of locoregional non-surgical and systemic therapies. Locoregional therapies and surgical procedures should not be seen as competing, but as complementary treatment options. Locoregional therapies are of value if surgery is not possible; in the context of transplantation they have an important role as ‘downstaging procedures’ allowing for bringing of transplantable patients into the required inclusion criteria. Systemic therapies and living donor liver transplantation will without any doubt occupy a more important role in the future therapeutic scheme of HCC.

About the authors

J. Lerut

University Hospitals Saint Luc, Université Catholique de Louvain

Author for correspondence.
Email: jan.lerut@uclouvain.be

Jan Lerut – MD, PhD, Professor.

10, Hippocrates avenue, 1200 Brussels, tel.: + 32 475 85 95 04, Fax: + 32 2 764 90 39

Belgium

S. Iesari

University of L’Aquila

Email: fake@neicon.ru

Samuele Iesari – MD, Department of Biotechnological and Applied Clinical Sciences.

25 Via Giovanni Falcone, Coppito (AQ), 67100

Italy

M. Foguenne

University Hospitals Saint Luc, Université Catholique de Louvain

Email: fake@neicon.ru

Maxime Foguenne – MD, Starzl Unit Abdominal Transplantation.

10 Hippocrates avenue, Brussels, 1200

Belgium

K. Ackenin

University Hospitals Saint Luc, Université Catholique de Louvain

Email: fake@neicon.ru

Kevin Ackenin – MD, Starzl Unit Abdominal Transplantation.

10 Hippocrates avenue, Brussels, 1200

Belgium

Q. Lai

La Sapienza University

Email: fake@neicon.ru

Quirino Lai – MD, PhD, Department of General Surgery and Organ Transplantation.

5 Piazzale Aldo Moro, Roma, 00185

Italy

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