Expanding Indications for Liver Transplantation in the Treatment of Hepatocellular Carcinoma.
Rachel V T HogenTara BarryVijay SubramanianPublished in: Current oncology (Toronto, Ont.) (2024)
Improvements in downstaging therapies have expanded the indications for liver transplantation (LT) for hepatocellular carcinoma (HCC). Patients with more advanced disease are now considered candidates due to advancements in radiation therapy, combination therapies, and immunotherapy. Combination stereotactic body radiation therapy (SBRT) and trans-arterial chemoembolization (TACE) has been shown to be superior to the historic treatment, sorafenib, in patients with macrovascular invasion. These patients are now candidates for LT with stable disease after LRT. Patients with ruptured HCC and prolonged stability have also been shown to have acceptable outcomes. The role of neoadjuvant immunotherapy needs to be further defined and has the potential to further improve tumor control prior to transplant.
Keyphrases
- radiation therapy
- end stage renal disease
- chronic kidney disease
- locally advanced
- ejection fraction
- newly diagnosed
- type diabetes
- radiation induced
- climate change
- subarachnoid hemorrhage
- combination therapy
- risk assessment
- metabolic syndrome
- patient reported outcomes
- insulin resistance
- radiofrequency ablation
- brain injury
- replacement therapy
- smoking cessation