[Usefulness of pre-surgical biopsy in selecting patients with hepatocellular carcinoma for liver transplant].
The selection of patients with hepatocellular carcinoma (HCC) for liver transplantation must be improved. One of the methods proposed to achieve this objective consists of including predictors of tumour aggressiveness to the decision making algorithm. The procedures that would enable this characteristic to be assessed, are: 1. Serum biomarkers, 2. Response to transarterial chemoembolisation and 3. Data on the tumour histology. In this review, the available data on the usefulness of each of these procedures are analysed. Special attention is given to the evidence associated with the possible usefulness of a preoperative biopsy. It can be concluded that a preoperative biopsy could be useful to indicate liver transplantation in patients with extended criteria, but not in patients that fulfil the Milan criteria. This scenario could soon change if the initial data on the prognostic value of some molecular markers of tumour progression are confirmed.
Ramos Rubio
Emilio
E
Unidad de Trasplante Hepático, Servicio de Cirugía General y Digestiva, Hospital Universitario de Bellvitge, Barcelona, España. eramos@bellvitgehospital.cat
Llado Garriga
Laura
L
D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D016031:Liver Transplantation; D018579:Patient Selection; D011300:Preoperative Care; D011379:Prognosis