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World J Meta-Anal. Apr 28, 2022; 10(2): 46-51
Published online Apr 28, 2022. doi: 10.13105/wjma.v10.i2.46
Is there a role for liver transplantation in the treatment of hepatocellular carcinoma in non-cirrhotic liver?
Luis Cesar Bredt, Ingryd Betina Garcia Felisberto, Doroty Eva Garcia Felisberto
Luis Cesar Bredt, Surgical Oncology and Hepatobiliary Surgery, Unioeste University, Cascavel 85819-110, Paraná, Brazil
Ingryd Betina Garcia Felisberto, Internal Medicine, Univates University, Lajeado 95914-014, Rio Grande do Sul, Brazil
Doroty Eva Garcia Felisberto, Department of Surgery, Nossa Senhora das Graças Hospital, Curitiba 80810-040, Paraná, Brazil
Author contributions: All authors contributed equally to this review article; all authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Luis Cesar Bredt, FRCS (Hon), PhD, Full Professor, Surgical Oncologist, Surgical Oncology and Hepatobiliary Surgery, Unioeste University, R. Universitária, 2069, Cascavel 85819-110, Paraná, Brazil. lcbredt@gmail.com
Received: December 23, 2021
Peer-review started: December 23, 2021
First decision: March 10, 2022
Revised: March 21, 2022
Accepted: April 28, 2022
Article in press: April 28, 2022
Published online: April 28, 2022
Abstract

Whether liver transplantation (LT) plays a role in the treatment of patients with hepatocellular carcinoma (HCC) in non-cirrhotic liver (NCL) is a matter of debate. The recommendations for LT in this setting are extremely fragile and less well-defined than for cirrhosis-associated HCC. All reports of LT for NCL-HCC revealed that long-term outcomes of these patients are poor, and these dismal figures are justified by the advanced tumor stage at the time of LT, suggesting the presence of systemic micrometastatic disease. The decision-making regarding LT for NCL-HCC is difficult, since specific selection criteria are scarce, and basically the potential candidates are those with unresectable only-liver tumor at admission, or unresectable intrahepatic recurrence post-resection. Besides the surgical aspects regarding the tumor resectability, other phenotypic and genetic characteristics of the tumor should be considered for the indication of LT in this scenario. The present minireview aims to discuss and analyze the last series of LT for NCL-HCC, in order to help clinicians in the decision-making process regarding the role of LT in NCL-HCC treatment.

Keywords: Liver transplantation, Non-cirrhotic liver, Liver, Cancer, Hepatocellular carcinoma, Treatment

Core Tip: The present manuscript aims to discuss and analyze the last series of liver transplantation for hepatocellular carcinoma in non-cirrhotic liver, with a special focus on the indications, prognostic factors and long-term outcomes, in order to help clinicians in the decision-making regarding the role of liver transplantation in the non-cirrhotic liver –hepatocellular carcinoma scenario on the basis of these analyses.