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World J Gastroenterol. Nov 21, 2013; 19(43): 7515-7530
Published online Nov 21, 2013. doi: 10.3748/wjg.v19.i43.7515
Published online Nov 21, 2013. doi: 10.3748/wjg.v19.i43.7515
Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation
Maurizio Pompili, Francesca Romana Ponziani, Department of Internal Medicine, Università Cattolica del Sacro Cuore, 8-00168 Rome, Italy
Roberto Iezzi, Department of Bioimaging and Radiological Sciences, Università Cattolica del Sacro Cuore, 8-00168 Rome, Italy
Alfonso Wolfango Avolio, Transplant Center, Catholic University, 1-00168 Rome, Italy
Giampiero Francica, Interventional Ultrasound Unit, Pinetagrande Hospital, 81030 Castelvolturno, Italy
Author contributions: Pompili M designed the study, wrote the manuscript, and revised the final version of the article; Francica G, Ponziani FR, Iezzi R and Avolio AW contributed to the literature search and writing the manuscript.
Correspondence to: Maurizio Pompili, MD, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8-00168 Roma, Italy. mpompili@rm.unicatt.it
Telephone: +39-6-30154334 Fax: +39-6-35502775
Received: August 28, 2013
Revised: October 15, 2013
Accepted: October 17, 2013
Published online: November 21, 2013
Processing time: 112 Days and 8.1 Hours
Revised: October 15, 2013
Accepted: October 17, 2013
Published online: November 21, 2013
Processing time: 112 Days and 8.1 Hours
Core Tip
Core tip: The bridging treatments for patients with hepatocellular carcinoma within Milan criteria listed for liver transplantation are useful in decreasing dropout rate from the waiting list and the experiences reported to date suggest a positive impact on post-transplant tumor recurrence and patient survival. The response to treatments may represent a surrogate marker of tumor biological aggressiveness and could be evaluated to prioritize hepatocellular carcinoma candidates in the waiting list. Advanced hepatocellular carcinoma may be downstaged to achieve the current conventional criteria for inclusion in the waiting list and successfully downstaged patients can achieve an excellent 5-year survival rate.