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World J Hepatol. Sep 18, 2015; 7(20): 2309-2314
Published online Sep 18, 2015. doi: 10.4254/wjh.v7.i20.2309
Progress in the treatment of pulmonary metastases after liver transplantation for hepatocellular carcinoma
Zhan-Wang Xiang, Lin Sun, Guo-Hong Li, Rakesh Maharjan, Jin-Hua Huang, Chuan-Xing Li
Zhan-Wang Xiang, Lin Sun, Guo-Hong Li, Rakesh Maharjan, Jin-Hua Huang, Chuan-Xing Li, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong Province, China
Author contributions: Xiang ZW and Sun L contributed equally to this work; Li CX and Huang JH designed research; Xiang ZW, Sun L, Li GH and Li CX performed research; Xiang ZW, Sun L and Maharjan R analyzed data; Xiang ZW and Sun L wrote the paper; all authors had read and approved the final manuscript to be published.
Supported by National Natural Science Foundation of China, No. 81371652 (to Huang JH).
Conflict-of-interest statement: The authors declare there is no conflict of interest in this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chuan-Xing Li, MD, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651 Dongfeng East Road, Guangzhou 510060, Guangdong Province, China. lichuanh@mail.sysu.edu.cn
Telephone: +86-20-87343901 Fax: +86-20-87343901
Received: April 16, 2015
Peer-review started: April 19, 2015
First decision: June 2, 2015
Revised: June 19, 2015
Accepted: September 2, 2015
Article in press: September 7, 2015
Published online: September 18, 2015
Abstract

Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world, and is the third leading cause of cancer-related death. Liver transplantation (LT) has become a curative treatment for patients with HCC. However, recurrence and metastasis after LT are the main factors reducing long-term survival in patients, and the lung is the most common site of metastasis after LT for HCC, although metastasis to liver, para-aortic lymph nodes and renal periphery are observed. Thus, the treatment of pulmonary metastases after LT for HCC has become a hot research topic, the successful treatment of pulmonary metastases can significantly prolong the survival of LT patients. Although single conventional treatment (chemotherapy, surgery and external beam radiation therapy), immunosuppression, image-guided minimally invasive therapy (radiofrequency ablation, microwave ablation, cryoablation, and brachytherapy) and molecular targeted drugs have had a significant effect, patients do not have durable remission and the long-term survival rate is disappointing. Therefore, improving existing treatments and identifying a more effective combination therapy are important research issues in the prevention and treatment of pulmonary metastases after LT for HCC. The paper reviewed single conventional treatments, new treatments, and combination therapy, to provide a basis for the best treatment of these patients.

Keywords: Liver transplantation, Progress, Treatment, Pulmonary metastases, Hepatocellular carcinoma

Core tip: The treatment of pulmonary metastases after liver transplantation for hepatocellular carcinoma has become a hot research topic. Although single conventional treatment (chemotherapy, surgery and external beam radiation therapy), image-guided minimally invasive therapy (radiofrequency ablation, microwave ablation, cryoablation, and brachytherapy) and molecular targeted drugs have had a significant effect, patients do not have durable remission and the long-term survival rate is disappointing. Therefore, we reviewed single conventional treatments, new treatments, and combination therapy, to provide a basis for the best treatment of these patients.