Lang SA, Bednarsch J, Czigany Z, Joechle K, Kroh A, Amygdalos I, Strnad P, Bruns T, Heise D, Ulmer F, Neumann UP. Liver transplantation in malignant disease. World J Clin Oncol 2021; 12(8): 623-645 [PMID: 34513597 DOI: 10.5306/wjco.v12.i8.623]
Corresponding Author of This Article
Sven Arke Lang, FEBS, MD, Professor, Surgeon, Department of Surgery and Transplantation, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany. svlang@ukaachen.de
Research Domain of This Article
Tropical Medicine
Article-Type of This Article
Review
Open-Access Policy of This Article
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/
World J Clin Oncol. Aug 24, 2021; 12(8): 623-645 Published online Aug 24, 2021. doi: 10.5306/wjco.v12.i8.623
Liver transplantation in malignant disease
Sven Arke Lang, Jan Bednarsch, Zoltan Czigany, Katharina Joechle, Andreas Kroh, Iakovos Amygdalos, Pavel Strnad, Tony Bruns, Daniel Heise, Florian Ulmer, Ulf Peter Neumann
Sven Arke Lang, Jan Bednarsch, Zoltan Czigany, Katharina Joechle, Andreas Kroh, Iakovos Amygdalos, Daniel Heise, Florian Ulmer, Ulf Peter Neumann, Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen 52074, Germany
Pavel Strnad, Tony Bruns, Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen 52074, Germany
Author contributions: Lang SA contributed to conception and design, acquisition of data, drafting the article, critical revision for important content, and final approval of the article; Neumann UP contributed to conception and design, critical revision and final approval; Ulmer F, Heise D, Bruns T, Strnad P contributed to critical revision and final approval; Bednarsch J, Czigany Z, Joechle K, Amygdalos I contributed to critical revision, data acquisition and final approval.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sven Arke Lang, FEBS, MD, Professor, Surgeon, Department of Surgery and Transplantation, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen 52074, Germany. svlang@ukaachen.de
Received: February 24, 2021 Peer-review started: February 24, 2021 First decision: May 7, 2021 Revised: June 15, 2021 Accepted: July 23, 2021 Article in press: July 23, 2021 Published online: August 24, 2021
Abstract
Liver transplantation for malignant disease has gained increasing attention as part of transplant oncology. Following the implementation of the Milan criteria, hepatocellular carcinoma (HCC) was the first generally accepted indication for transplantation in patients with cancer. Subsequently, more liberal criteria for HCC have been developed, and research on this topic is still ongoing. The evident success of liver transplantation for HCC has led to the attempt to extend its indication to other malignancies. Regarding perihilar cholangiocarcinoma, more and more evidence supports the use of liver transplantation, especially after neoadjuvant therapy. In addition, some data also show a benefit for selected patients with very early stage intrahepatic cholangiocarcinoma. Hepatic epithelioid hemangioendothelioma is a very rare but nonetheless established indication for liver transplantation in primary liver cancer. In contrast, patients with hepatic angiosarcoma are currently not considered to be optimal candidates. In secondary liver tumors, neuroendocrine cancer liver metastases are an accepted but comparability rare indication for liver transplantation. Recently, some evidence has been published supporting the use of liver transplantation even for colorectal liver metastases. This review summarizes the current evidence for liver transplantation for primary and secondary liver cancer.
Core Tip: This review focuses on the role of liver transplantation in the treatment of primary and secondary liver cancer. Particularly, we summarize the selection criteria for hepatocellular carcinoma and the available evidence for liver transplantation in perihilar and intrahepatic cholangiocarcinoma. Very rare indications such as hepatic epithelioid hemangioendothelioma, fibrolamellar carcinoma, hepatic angiosarcoma and undifferentiated embryonal sarcoma of the liver are reviewed. In secondary liver cancer, neuroendocrine liver metastases constitute the only established indication so far, and the existing data is recapitulated. Regarding colorectal liver metastases, current novel evidence and ongoing studies are summarized.
