title: [Liver transplantation for hepatocellular carcinoma].
abstract: Hepatocellular carcinoma (HCC) is the most frequent primitive cancer of the liver. It mostly develops on cirrhotic livers. Orthotopic liver transplantation is the only treatment that definitively addresses both the metachronous occurrence risk of HCC and the underlying disease. Under Milan criteria, i.e. less than 3 nodules of 3 cm max in diameter, or 1 nodule of 5 cm maximum, OLT has been shown effective and provides with survival rates almost equal to those obtained with HCC free cirrhotic patients. In Rennes, 195 patients with early HCC on cirrhotic livers have been transplanted from January 1995 to June 2005. Global and disease free 8 years patient survival rates were 73 and 70%, respectively. These results were significantly altered when the recipient was female, the cirrhosis due to C virus and the patient of B blood group. Despite these excellent results, the principal limit to the application of transplantation for HCC remains the long period of time patients have to wait for a graft. During this period of time, growth of the tumour may drop the patient out of Milan criteria and subsequently from the waiting list. The role of chemoembolisation, liver resection and thermal ablation while the patient is waiting for a graft remains debatable.
authors.affiliation: Département de chirurgie viscérale, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 09, France. karim.boudjema@chu-rennes.fr
authors.forename: Karim
authors.initials: K
authors.lastname: Boudjema
authors.forename: Philippe
authors.initials: P
authors.lastname: Compagnon
authors.forename: Eric
authors.initials: E
authors.lastname: Dupont-Bierre
authors.forename: Richard
authors.initials: R
authors.lastname: Lorho
authors.forename: Mohamed
authors.initials: M
authors.lastname: Lakehal
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Thirouard
authors.forename: Bernard
authors.initials: B
authors.lastname: Meunier
authors.forename: Michel
authors.initials: M
authors.lastname: Messner
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D014850:Waiting Lists