Liver Transplantation for the Treatment of Small Hepatocellular Carcinomas in Patients with Cirrhosis

The value of orthotopic liver transplantation in the treatment of hepatocellular carcinoma has often been debated. Although liver replacement could be curative for patients with tumors confined to the liver, the long-term results of liver transplantation in patients with hepatocellular carcinoma have been disappointing, with an overall five-year survival rate ranging from 30 to 40 percent. 1-9 In recent years, revisions of the tumor–node–metastasis (TNM) classification system 9 and other systems for determining the stage of hepatocellular carcinoma 10 have made possible a more detailed, retrospective analysis of treatment in these patients. In several studies, tumor stage before transplantation was directly related to . . .