Journal of Gastrointestinal Cancer

, Volume 48, Issue 3, pp 219–221 | Cite as

New Paradigm: Adaptive Approach

  • Hikmet AkkızEmail author
Review Article

Hepatocellular carcinoma (HCC) is a major health problem worldwide which continues to increase. HCC is one of the leading causes of cancer-related death and is currently the main event leading to death in patients with cirrhosis. HBV and HCV infections are major risk factors of HCC [1]. Non-alcoholic steatohepatitis has recently emerged a relevant risk factor. The molecular pathogenesis is extremely complex and heterogeneous. Our understanding of the molecular pathogenesis of HCC has improved significantly in the last decade. Certainly, cumulative data from high-throughput analysis of large number of samples have provided an accurate landscape of HCC genetic alterations [2]. But, to date, the molecular information has not impacted on treatment decision. Liver transplantation for HCC is the best treatment option for patients with early-stage tumors and account for approximately 20–40% of all liver transplantations performed at most centers worldwide [2]. The Milan criteria are the most...


  1. 1.
    Mazzaferro V. Squaring the circle of selection nd allocation in liver transplantation for HCC : an adaptive approach. Hepatology. 2016;63:1707–17.CrossRefGoogle Scholar
  2. 2.
    Halazun, et al. Standing the test of time : outcomes of a decade prioritizing patients with hepatocellular carcinoma, results of the UNOS natural geographic experiment. Hepatology. 2014;60:1957–62.CrossRefGoogle Scholar
  3. 3.
    Belli LS, Berenguer M, Cortesi B, et al. Impact of direct anti-viral agents on inactivation /de-listing of liver transplant candidates listed for decompensated C cirrhosis : a European study. J Hepatol. Google Scholar
  4. 4.
    Bruix J, Gores GJ, Mazzaferro V. Hepatocellular carcinoma : clinical features and perspectives. Gut. 2014;47:844–55.CrossRefGoogle Scholar
  5. 5.
    Sapisochin G, Bruix J. Liver transplantation for hepatocellular carcinoma : outcomes and novel surgical approaches. Nature Reviews/Gastroenterology and Hepatology. 2017;2017:1–15.Google Scholar
  6. 6.
    Yao FY, Mehta N, Flemming J, et al. Down staging of hepatocellular cancer before liver transplant: long-term outcome compored to tumors within Milan criteria. Hepatology. 2015;61:1968–77.CrossRefGoogle Scholar
  7. 7.
    Piscaglia F, Svegliati-Baroni G, Burchetti A, et al. Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease : a multicenter prospective study. Hepatology. 2016;63:827–38.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Çukurova UniversityAdanaTurkey

Personalised recommendations