Frankul Leana, Frenette Catherine
Scripps Center for Organ Transplant, Scripps Clinic/Green Hospital, La Jolla, CA, USA.
J Clin Transl Hepatol. 2021 Apr 28;9(2):220-226. doi: 10.14218/JCTH.2020.00037. Epub 2021 Mar 22.
Hepatocellular carcinoma (HCC) ranks among the leading cancer-related causes of morbidity and mortality worldwide. Downstaging of HCC has prevailed as a key method to curative therapy for patients who present with unresectable HCC outside of the listing criteria for liver transplantation (LT). Even though LT paves the way to lifesaving curative therapy for HCC, perpetually severe organ shortage limits its broader application. Debate over the optimal protocol and assessment of response to downstaging treatment has fueled immense research activity and is pushing the boundaries of LT candidate selection criteria. The implicit obligation of refining downstaging protocol is to ensure the maximization of the transplant survival benefit by taking into account the waitlist life expectancy. In the following review, we critically discuss strategies to best optimize downstaging HCC to LT on the basis of existing literature.
肝细胞癌（HCC）是全球癌症相关发病和死亡的主要原因之一。对于不符合肝移植（LT）列入标准但出现不可切除HCC的患者，HCC降期已成为治愈性治疗的关键方法。尽管LT为HCC的挽救性治愈性治疗铺平了道路，但长期严重的器官短缺限制了其更广泛的应用。关于最佳方案以及对降期治疗反应评估的争论推动了大量研究活动，并正在突破LT候选者选择标准的界限。完善降期方案的内在责任是通过考虑等待名单上的预期寿命来确保移植生存获益最大化。在以下综述中，我们根据现有文献批判性地讨论将HCC最佳降期至LT的策略。
