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  • 1 Clinic for Transplantation and Surgery, Semmelweis University, Budapest, Hungary
  • 2 Baross u. 23–25, H-1082, Budapest, Hungary
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Abstract

Hepatocellular carcinoma, which has developed in liver cirrhosis is a disease where liver transplantation can provide a cure both for the tumour and the underlying liver damage. However, patients can only be transplanted when the tumour number and size do not exceed the Milan criteria. Tumour ablation methods — such as radiofrequency ablation — can provide a chance to make the patient eligible for transplantation. Among the 416 Hungarian liver transplanted patients there are 6 who had received different types of ablative therapy as bridging therapy in different institutions. On the basis of analysis of the patients' data we created a guideline for the treatment of cirrhotic patients with hepatocellular carcinoma with the aim of developing a uniform Hungarian approach.

  • 1. J.M. Llovet A. Burroughs J. Bruix 2003 Hepatocellular carcinoma The Lancet 362 1907 1917.

  • 2. Y. Ishizaki S. Kawasaki 2008 The evolution of liver transplantation for hepatocellular carcinoma (past, present, and future) J Gastroenterol 43 18 26.

    • Search Google Scholar
    • Export Citation
  • 3. D.S. Lu N.C. Yu S.S. Raman C. Lassman M.J. Tong C. Britten F. Durazo S. Saab S. Han R. Finn J.R. Hiatt R.W. Busuttil 2005 Percutaneous radiofrequency ablation of hepatocellular carcinoma as a bridge to liver transplantation Hepatology 41 5 1130 1137.

    • Search Google Scholar
    • Export Citation
  • 4. E.W. Johnson P.S. Holck A.E. Levy M.M. Yeh R.S. Yeung 2004 The Role of Tumor Ablation in Bridging Patients to Liver Transplantation Arch Surg 139 825 830.

    • Search Google Scholar
    • Export Citation
  • 5. Galandi D , Antes G: Radiofrequency thermal ablation versus other interventions for hepatocellular carcinoma (Cochrane Review). The Cochrane Library, Issue 2 (2004).

    • Search Google Scholar
    • Export Citation
  • 6. O.M. Ebied M.P. Federle B.I. Carr K.M. Pealer W. Li N. Amesur A. Zajko 2003 Evaluation of Responses to Chemoembolization in Patients with Unresectable Hepatocellular Carcinoma Cancer 97 1042 1050.

    • Search Google Scholar
    • Export Citation
  • 7. R.A. Lencioni H.P. Allgaier D. Cioni M. Olschewski P. Deibert L. Crocetti H. Frings J. Laubenberger I. Zuber H.E. Blum C. Bartolozzi 2003 Small Hepatocellular Carcinoma in Cirrhosis: Randomized Comparison of Radio-frequency Thermal Ablation versus Percutaneous Ethanol Injection Radiology 228 235 240.

    • Search Google Scholar
    • Export Citation
  • 8. B. Nemes W. Polak G. Ther H. Hendriks L. Kóbori R.J. Porte E. Sárváry K.P. de Jong A. Doros Z. Gerlei A.P. van der Berg I. Fehérvári D. Görög P.M. Peeters J. Járay M.J. Slooff 2006 Analysis of Differences in Outcome of Two European Liver Transplant Centers Transplant International 19 372 380.

    • Search Google Scholar
    • Export Citation
  • 9. Z. Bánsághi 2008 A rádiófrekvenciás ablatio helye a malignus daganatok kezelésében. Lehet ségek és korlátok Magyar Sebészet 61 2 59 64.

    • Search Google Scholar
    • Export Citation
  • 10. V. Mazzaferro E. Regalia R. Doci S. Andreola A. Pulvirenti F. Bozzetti F. Montalto M. Ammatuna A. Morabito L. Gennari 1996 Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis N Engl J Med 334 693 699.

    • Search Google Scholar
    • Export Citation
  • 11. A. Lubienski 2005 Hepatocellular carcinoma: interventional bridging to liver transplantation Transplantation 80 1Suppl S113 S119.

  • 12. R.T. Poon S.T. Fan C.M. Lo C.L. Liu J. Wong 2002 Long term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation Ann Surg 235 373 382.

    • Search Google Scholar
    • Export Citation
  • 13. J. Belghiti A. Cortes E.K. Abdalla J.M. Regimbeau K. Prakash F. Durand D. Sommacale F. Dondero M. Lesurtel A. Sauvanet O. Farges R. Kianmanesh 2003 Resection prior to liver transplantation for hepatocellular carcinoma Ann Surg 238 885 893.

    • Search Google Scholar
    • Export Citation
  • 14. Y.K. Maddala L. Stadheim J.C. Andrews L.J. Burgart C.B. Rosen W.K. Kremers G. Gores 2004 Drop-out rates of patients with hepatocellular cancer listed for liver transplantation: Outcome with chemoembolization Liver Transpl 10 449 455.

    • Search Google Scholar
    • Export Citation
  • 15. P.H. Hayashi M. Ludkowski L.M. Forman M. Osgood S. Johnson M. Kugelmas J.F. Trotter T. Bak M. Wachs I. Kam J. Durham G.T. Everson 2004 Hepatic artery chemoembolization for hepatocellular carcinoma in patients listed for liver transplantation Am J Transplant 4 782 787.

    • Search Google Scholar
    • Export Citation
  • 16. M. Omata R. Tateishi H. Yoshida S. Shiina 2004 Treatment of hepatocellular carcinoma by percutaneous tumor ablation methods: Ethanol injection therapy and radiofrequency ablation Gastroenterology 127 S159 S166.

    • Search Google Scholar
    • Export Citation
  • 17. R. Lencioni L. Crocetti P. Petruzzi C. Vignali E. Bozzi C. della Pina I. Bargellini D. Cioni F. Oliveri P. de Simone C. Bartolozzi M. Brunetto F. Filippon 2008 Doxorubicin-eluting bead-enhanced radiofrequency ablation of hepatocellular carcinoma: A pilot clinical study Journal of Hepatology 49 217 222.

    • Search Google Scholar
    • Export Citation
  • 18. N. Yamashiki R. Tateishi H. Yoshida S. Shiina T. Teratani S. Sato N. Mine Y. Kondo T. Kawabe M. Omata 2005 Ablation Therapy in Containing Extension of Hepatocellular Carcinoma: A Simulative Analysis of Dropout From the Waiting List for Liver Transplantation Liver Transplantation 11 508 514.

    • Search Google Scholar
    • Export Citation
  • 19. M. Pompili V.G. Mirante G. Rondinara L.R. Fassati F. Piscaglia S. Agnes M. Covino M. Ravaioli S. Fagiuoli G. Gasbarrini G.L. Rapaccini 2005 Percutaneous ablation procedures in cirrhotic patients with hepatocellular carcinoma submitted to liver transplantation: Assessment of efficacy at explant analysis and of safety for tumor recurrence Liver Transplantation 11 1117 1126.

    • Search Google Scholar
    • Export Citation
  • 20. R.D. Kim A.I. Reed S. Fujita D.P. Foley K.L. Mekeel A.W. Hemming 2007 Consensus and Controversy in the Management of Hepatocellular Carcinoma J Am Coll Surg 205 108 123.

    • Search Google Scholar
    • Export Citation