Moeckli Beat, Ivanics Tommy, Claasen Marco, Toso Christian, Sapisochin Gonzalo
Department of Visceral and Transplantation Surgery, University of Geneva Hospitals, Geneva, Switzerland.
Multi-Organ Transplant Program, University Health Network, Toronto, ON, Canada.
Liver Int. 2020 Oct;40(10):2326-2344. doi: 10.1111/liv.14621.
Over the past two decades since the introduction of the Milan criteria, the field of transplant oncology has undergone a rapid development with a rising proportion of liver transplantations being performed for oncological indications. For many patients with liver tumours, transplantation represents the only chance for cure. However, many challenges remain, such as the adequate patient selection, management of post-transplant recurrence and refinement of neoadjuvant treatment protocols. This review provides an overview of the current state of the art of liver transplantation for oncological indications such as hepatocellular carcinoma, cholangiocarcinoma, colorectal liver metastasis and metastatic neuroendocrine tumours. We also summarize the ongoing research and explore future trends. Clinical trials are currently studying new diagnostic modalities, innovative pharmacological treatments, novel surgical techniques, downstaging regimens and new indications for liver transplantation. These emerging results will continue to shape the field of transplant oncology and provide us with the necessary tools to better select, treat and follow patients with liver tumours qualifying for liver transplantation.
自引入米兰标准以来的过去二十年里,移植肿瘤学领域发展迅速,因肿瘤适应症而进行的肝移植比例不断上升。对于许多肝肿瘤患者来说,移植是治愈的唯一机会。然而,仍存在许多挑战,如合适的患者选择、移植后复发的管理以及新辅助治疗方案的完善。本综述概述了肝细胞癌、胆管癌、结直肠癌肝转移和转移性神经内分泌肿瘤等肿瘤适应症的肝移植现状。我们还总结了正在进行的研究并探索未来趋势。目前,临床试验正在研究新的诊断方法、创新的药物治疗、新颖的手术技术、降期方案以及肝移植的新适应症。这些新出现的结果将继续塑造移植肿瘤学领域,并为我们提供必要的工具,以便更好地选择、治疗和随访符合肝移植条件的肝肿瘤患者。