7
69
Mazzaferro et al.38 have established liver transplant as
an effective treatment for small, unresectable HCC in
cirrhotic patients. The role of liver transplant for resect-
able HCC, however, remains a controversial topic.
Whereas some authors have been able to demonstrate a
clear survival advantage with transplant, others have
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1
1
3
9–43
shown no clear benefit over resection.
We were able
1
to demonstrate a significantly longer disease-free sur-
vival in HCC patients with HCV who were treated with
liver transplant when compared to resection. The same
was not true for those with HBV. Given that cirrhosis
places individuals at risk for HCC and that HCC patients
with HCV were much more likely to have cirrhosis, it is
not surprising that transplant would result in fewer re-
currences, because it involves removal of the recipient
liver, which is predisposed to tumorigenesis.
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1
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significant differences in preoperative status, tumor char-
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patients with chronic HBV and HCV infection who have
not yet reached end-stage liver disease. A 3-year disease-
free survival of less than 10% after resection makes a
compelling argument for transplanting resectable cases
of HCC with concomitant HCV, especially in light of the
substantially higher disease-free survival rates achieved
in these patients after transplant.
1
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