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Review Article
- Surgical Perspectives of Hepatocellular Carcinoma beyond the Barcelona Clinical Liver Cancer Guideline; Focusing on Liver Transplantation
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Nam-Joon Yi, Gwang-Woong Lee, Kyoung-Suk Suh
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J Liver Cancer. 2015;15(1):4-10. Published online March 31, 2015
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DOI: https://doi.org/10.17998/jlc.15.1.4
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Abstract
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- The management of hepatocellular carcinoma (HCC) is decided according to the evidence
base recommendations generated by international societies especially by Barcelona clinical
liver cancer (BCLC) guideline. However, the BCLC guideline based on studies of the Western
countries, has not been well matched to real life cohort in Korea. In Western countries,
a deceased donor liver transplantation has been well allocated to the HCC patients with
preserved liver function. Patients with mild to moderate portal hypertension and certain
BCLC B patients could be eligible for hepatic resection if a chance for 50% survival rate at 5
years is perceived. If liver transplantation (LT) is back up for liver resection in those patients
as a salvage therapy, widening indication of liver resection could be much easily acceptable.
On the other hands, new selection criteria of HCC beyond Milan criteria considering tumor
biology, has been provided in the field of LT resulting in more than 50% survival rate at 5
years. Herein, surgical perspectives beyond the BCLC recommendation for LT for HCC would
be reviewed in the respect of Korean surgeon’s view in this article.
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