General overview of neo-adjuvant therapy for hepatocellular carcinoma before liver transplantation: necessity or option?
Article first published online: 15 FEB 2011
© 2011 John Wiley & Sons A/S
Volume 31, Issue 8, pages 1081–1089, September 2011
How to Cite
Fujiki, M., Aucejo, F. and Kim, R. (2011), General overview of neo-adjuvant therapy for hepatocellular carcinoma before liver transplantation: necessity or option?. Liver International, 31: 1081–1089. doi: 10.1111/j.1478-3231.2011.02473.x
- Issue published online: 5 JUN 2011
- Article first published online: 15 FEB 2011
- Received 12 November 2010, Accepted 11 January 2011
- liver transplantation;
- locoregional therapy;
- neo-adjuvant therapy
Because of its increasing incidence of hepatocellular carcinoma, it is now recognized as a worldwide health problem affecting mostly patients with chronic liver disease. Liver transplantation is the optimal therapy and achieves its best results in patients with small tumour burden. In an effort to prevent tumour progression and patient dropout from the transplant wait list, the concept and utilization of neo-adjuvant locoregional therapies have gained relevance in the past few years. Moreover, good and maintained response to therapy is now considered a surrogate of favourable tumour biology, therefore aiding the patient transplant selection process. Herein, we review the current role of neo-adjuvant therapies and revise concepts of tumour ‘downstaging’ or ‘bridging therapy’ in the setting of liver transplantation. In addition, we explore the debate of implementing locoregional therapy for patients with small tumours and short waiting times to liver transplantation.