Although liver transplantation has become an effective solution to treat liver cancer, not all liver cancer patients are eligible for liver transplantation. What types of liver cancer patients are eligible for liver transplantation, then?
On Asan Medical Center's YouTube channel, Professor Jung Dong-hwan of the Department of Liver Transplantation and Hepatobiliary Surgery explained that the best candidates for liver transplantation are those with "a diameter of 5 cm or less in the case of a single tumor or 3 cm or less in the case of multiple tumors, each with a diameter of 3 cm or less and no major vascular invasion or metastases outside of the liver."
According to Professor Jung, these are the criteria for liver transplantation according to the Milan Scale, and if treated, the five-year survival rate is over 80 percent. However, not all liver cancer patients who fall outside of these criteria have a bad outcome for liver transplantation, he added.
Several recent studies have shown that some patients with liver cancer outside the Milan Scale can be treated with liver transplantation, with five-year survival rates exceeding 80 percent. So, which liver cancer patients do well with liver transplantation?
"Even if patients are outside the Milan Scale, liver transplantation can be performed if the stage is eased by local treatment, transcatheter chemoembolization, or other treatments," Professor Jung said. "A scale that includes tumor markers in addition to tumor size and number has been developed recently, expanding the scope of patients applicable to liver transplantation."
In addition, liver transplantation has been shown to have good outcomes in patients who have previously undergone liver resection for liver cancer when the cancer returns. Some patients with liver cancer urgently need a liver transplant, another expert said.
"Even in the early stages of liver cancer, if liver function is poor due to cirrhosis, liver transplantation should be performed," said Professor Lee Suk-koo at Myongji Hospital, on the hospital's YouTube channel. “However, liver transplantation cannot be performed if the cancer has invaded major blood vessels or metastasized to organs such as lungs or bones.”
The reason why liver transplantation is not possible in advanced liver cancer is because most liver transplants are currently performed using living donor livers, he explained.
"Because living donor liver transplantation is limited for advanced liver cancer, early detection is very important for liver cancer, just like other cancers," Professor Lee added.