tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncowebtumors-283Research ArticleСтатьиК ВОПРОСУ О ТРАНСПЛАНТАЦИИ ПЕЧЕНИ У БОЛЬНЫХ ГЕПАТОЦЕЛЛЮЛЯРНОЙ КАРЦИНОМОЙ (КРАТКИЙ ОБЗОР ЛИТЕРАТУРЫ)НоврузбековМ. С.NovruzbekovM. S.

Новрузбеков Мурад Сафтарович – кандидат медицинских наук, заведующий научным отделом трансплантации печени

ОлисовО. Д.OlisovO. D.

Олисов Олег Даниелович – кандидат медицинских наук, старший научный сотрудник отдела трансплантации печени

Olisov@gmail.comНаучно-исследовательский институт скорой помощи имени Н. В. СклифосовскогоRussian Federation20161811201604s13639Copyright © Новрузбеков М.С., Олисов О.Д., 20162016Новрузбеков М.С., Олисов О.Д.Novruzbekov M.S., Olisov O.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/283

Гепатоцеллюлярная карцинома (ГЦК) – одна из наиболее распространенных опухолей, занимающая лидирующие позиции в структуре летальности от онкологического заболевания. Первичный рак печени устойчиво ассоциируется с наличием хронического диффузного заболевания печени – вирусного гепатита и цирроза. Ортотопическая трансплантация печени – альтернативный и, возможно – оптимальный метод лечения ГЦК, так как в результате операции полностью удаляется пораженный орган и предраковое заболевание. Отдаленные результаты ОТП зависят от стадии опухолевого поражения, инвазии опухоли в сосуды печени. Золотым стандартом в определении показаний к ОТП при ГЦК принято считать «Миланские критерии» и «Барселонскую» классификацию, обеспечивающие прекрасные отдаленные результаты. Вместе с тем, многими авторами данные критерии признаются излишне строгими, необоснованно лишающими значительную часть больных перспективы трансплантации печени.

гепатоцеллюлярная карциноматрансплантация печени«Миланские» критериирасширенные критерииReferencesKhan A.S, et al. Current surgical treatment strategies for hepatocellular carcinoma in North America. //World J Gastroenterol 2014; 20(41): 15007–15017.Khan A.S, et al. Current surgical treatment strategies for hepatocellular carcinoma in North America. //World J Gastroenterol 2014; 20(41): 15007–15017.Bruix J., Sherman M. Management of Hepatocellular Carcinoma: An update (AASLD practice guideline) // Hepatology. July 2010.Bruix J., Sherman M. Management of Hepatocellular Carcinoma: An update (AASLD practice guideline) // Hepatology. July 2010.Byam J, et al. Liver transplantation for hepatocellular carcinoma. // Hepatobiliary Surg Nutr 2013;2(1):22–30.Byam J, et al. Liver transplantation for hepatocellular carcinoma. // Hepatobiliary Surg Nutr 2013;2(1):22–30.Elshamy M, et al. Hepatocellular carcinoma beyond Milan criteria: Management and transplant selection criteria // World J Hepatol 2016 July 28; 8(21): 874–880.Elshamy M, et al. Hepatocellular carcinoma beyond Milan criteria: Management and transplant selection criteria // World J Hepatol 2016 July 28; 8(21): 874–880.Mazzaferro V., et al. Liver transplantation for hepatocellular carcinoma. // Annals of Surgical Oncology 15(4):1001–1007.Mazzaferro V., et al. Liver transplantation for hepatocellular carcinoma. // Annals of Surgical Oncology 15(4):1001–1007.Weledji E., et al. How grim is hepatocellular carcinoma? // Annals of Medicine and Surgery 3 (2014) 71–76.Weledji E., et al. How grim is hepatocellular carcinoma? // Annals of Medicine and Surgery 3 (2014) 71–76.Hackl C., et al. Liver transplantation for malignancy: current treatment strategies and future perspectives. // World J Gastroenterol 2014 May 14; 20(18): 5331–5344.Hackl C., et al. Liver transplantation for malignancy: current treatment strategies and future perspectives. // World J Gastroenterol 2014 May 14; 20(18): 5331–5344.Kornberg A. Liver transplantation for hepatocellular carcinoma beyond Milan criteria: multidisciplinary approach to improve outcome. // ISRN Hepatology, Vol. 2014 (2014), Article ID706945, 25 pages.Kornberg A. Liver transplantation for hepatocellular carcinoma beyond Milan criteria: multidisciplinary approach to improve outcome. // ISRN Hepatology, Vol. 2014 (2014), Article ID706945, 25 pages.Mazzaferro V, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. // N Engl J Med 1996; 334:693–699.Mazzaferro V, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. // N Engl J Med 1996; 334:693–699.Clavien et al. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. // Lancet Oncol. 2012 Jan; 13(1): e11–e22.Clavien et al. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. // Lancet Oncol. 2012 Jan; 13(1): e11–e22.Mehta N, et al. Outcomes after liver transplantation for patients with hepatocellular carcinoma and a low risk of dropout from the transplant waiting list. // Liver Transpl. 2014; 20(5): 627–628.Mehta N, et al. Outcomes after liver transplantation for patients with hepatocellular carcinoma and a low risk of dropout from the transplant waiting list. // Liver Transpl. 2014; 20(5): 627–628.Graziadei IW, et al. Chemoembolization followed by liver transplantation for hepatocellular carcinoma impedes tumor progression while on the waiting list and leads to excellent outcome. // Liver Transpl 9(6):557–63, Jun 2003.Graziadei IW, et al. Chemoembolization followed by liver transplantation for hepatocellular carcinoma impedes tumor progression while on the waiting list and leads to excellent outcome. // Liver Transpl 9(6):557–63, Jun 2003.Llovet JM, et al. Prognosis of hepatocellular carcinoma: the BCLC staging classification. // Semin Liver Dis. 1999;19:329–338.Llovet JM, et al. Prognosis of hepatocellular carcinoma: the BCLC staging classification. // Semin Liver Dis. 1999;19:329–338.Yao FY, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. // Hepatology 2001; 33: 1394–1403.Yao FY, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. // Hepatology 2001; 33: 1394–1403.Herrero JI, et al. Influence of tumor characteristics on the outcome of liver transplantation among patients with liver cirrhosis and hepatocellular carcinoma. // Liver Transpl 2001; 7: 631–636.Herrero JI, et al. Influence of tumor characteristics on the outcome of liver transplantation among patients with liver cirrhosis and hepatocellular carcinoma. // Liver Transpl 2001; 7: 631–636.Roayaie S, et al. Long-term results with multimodal adjuvant therapy and liver transplantation for the treatment of hepatocellular carcinomas larger than 5 centimeters. // Ann Surg 2002; 235: 533–539.Roayaie S, et al. Long-term results with multimodal adjuvant therapy and liver transplantation for the treatment of hepatocellular carcinomas larger than 5 centimeters. // Ann Surg 2002; 235: 533–539.Kneteman NM, et al. Sirolimus-based immunosuppression for liver transplantation in the presence of extended criteria for hepatocellular carcinoma. // Liver Transpl 2004; 10: 1301–131.Kneteman NM, et al. Sirolimus-based immunosuppression for liver transplantation in the presence of extended criteria for hepatocellular carcinoma. // Liver Transpl 2004; 10: 1301–131.Onaca N, et al. Expanded criteria for liver transplantation in patients with hepatocellular carcinoma: a report from the International Registry of Hepatic Tumors in Liver Transplantation. // Liver Transpl 2007; 13: 391–399.Onaca N, et al. Expanded criteria for liver transplantation in patients with hepatocellular carcinoma: a report from the International Registry of Hepatic Tumors in Liver Transplantation. // Liver Transpl 2007; 13: 391–399.Soejima Y, et al. Extended indication for living donor liver transplantation in patients with hepatocellular carcinoma. // Transplantation 2007; 83: 893–899.Soejima Y, et al. Extended indication for living donor liver transplantation in patients with hepatocellular carcinoma. // Transplantation 2007; 83: 893–899.Jonas S, et al. Living donor liver transplantation of the right lobe for hepatocellular carcinoma in cirrhosis in a European center. // Liver Transpl 2007; 13: 896–903.Jonas S, et al. Living donor liver transplantation of the right lobe for hepatocellular carcinoma in cirrhosis in a European center. // Liver Transpl 2007; 13: 896–903.Sugawara Y, et al. Living donor liver transplantation for hepatocellular carcinoma: Tokyo University series. // Dig Dis 2007; 25: 310–312.Sugawara Y, et al. Living donor liver transplantation for hepatocellular carcinoma: Tokyo University series. // Dig Dis 2007; 25: 310–312.Silva M, et al. Expanded criteria for liver transplantation in patients with cirrhosis and hepatocellular carcinoma. // Liver Transpl 2008; 14: 1449–1460.Silva M, et al. Expanded criteria for liver transplantation in patients with cirrhosis and hepatocellular carcinoma. // Liver Transpl 2008; 14: 1449–1460.Mazzaferro V, et al; Metroticket Investigator Study Group. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. // Lancet Oncol. 2009; 10: 35–43.Mazzaferro V, et al; Metroticket Investigator Study Group. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. // Lancet Oncol. 2009; 10: 35–43.Kwon CH, et al. HCC in living donor liver transplantation: can we expand the Milan criteria? // Dig Dis 2007; 25: 313–319.Kwon CH, et al. HCC in living donor liver transplantation: can we expand the Milan criteria? // Dig Dis 2007; 25: 313–319.Takada Y, et al. Living donor liver transplantation for patients with HCC exceeding the Milan criteria: a proposal of expanded criteria. // Dig Dis 2007; 25: 299–302.Takada Y, et al. Living donor liver transplantation for patients with HCC exceeding the Milan criteria: a proposal of expanded criteria. // Dig Dis 2007; 25: 299–302.Zheng SS, et al. Liver transplantation for hepatocellular carcinoma: Hangzhou experiences. // Transplantation 2008; 85: 1726–1732.Zheng SS, et al. Liver transplantation for hepatocellular carcinoma: Hangzhou experiences. // Transplantation 2008; 85: 1726–1732.Fujiki M, et al. Significance of des-gamma-carboxy prothrombin in selection criteria for living donor liver transplantation for hepatocellular carcinoma. // Am J Transplant 2009; 9: 2362–2371.Fujiki M, et al. Significance of des-gamma-carboxy prothrombin in selection criteria for living donor liver transplantation for hepatocellular carcinoma. // Am J Transplant 2009; 9: 2362–2371.Lai Q, et al. Combination of biological and morphological parameters for the selection of patients with hepatocellular carcinoma waiting for liver transplantation. // Clin Transplant 2012; 26: E125-E131.Lai Q, et al. Combination of biological and morphological parameters for the selection of patients with hepatocellular carcinoma waiting for liver transplantation. // Clin Transplant 2012; 26: E125-E131.Grąt M, et al. Combination of morphologic criteria and α-fetoprotein in selection of patients with hepatocellular carcinoma for liver transplantation minimizes the problem of posttransplant tumor recurrence. //World J Surg 2014; 38: 2698–2707.Grąt M, et al. Combination of morphologic criteria and α-fetoprotein in selection of patients with hepatocellular carcinoma for liver transplantation minimizes the problem of posttransplant tumor recurrence. //World J Surg 2014; 38: 2698–2707.Toso C, et al. Total tumor volume and alpha-fetoprotein for selection of transplant candidates with hepatocellular carcinoma: A prospective validation. // Hepatology 2015; 62: 158–165.Toso C, et al. Total tumor volume and alpha-fetoprotein for selection of transplant candidates with hepatocellular carcinoma: A prospective validation. // Hepatology 2015; 62: 158–165.Lee SD, et al. Clinical impact of 18F-Fluorodeoxyglucose positron emission tomography /computed tomography in living donor liver transplantation for advanced hepatocellular carcinoma. // Transplantation 2015; 99: 2142–2149.Lee SD, et al. Clinical impact of 18F-Fluorodeoxyglucose positron emission tomography /computed tomography in living donor liver transplantation for advanced hepatocellular carcinoma. // Transplantation 2015; 99: 2142–2149.See C. C., Sheung T. F. Selection of patients of hepatocellular carcinoma beyond the Milan criteria for liver transplantation. // Hepatobiliary Surg Nutr 2013;2(2):84–88.See C. C., Sheung T. F. Selection of patients of hepatocellular carcinoma beyond the Milan criteria for liver transplantation. // Hepatobiliary Surg Nutr 2013;2(2):84–88.Duffy J. P., et al. Liver transplantation criteria for hepatocellular carcinoma should be expanded: a 22-year experience with 467 patients at UCLA. // Ann Surg 2007;246: 502–511.Duffy J. P., et al. Liver transplantation criteria for hepatocellular carcinoma should be expanded: a 22-year experience with 467 patients at UCLA. // Ann Surg 2007;246: 502–511.Xu D. W., et al. Liver transplantation for hepatocellular carcinoma beyond the Milan criteria: A review. // World J Gastroenterol 2016; 22(12): 3325–3334.Xu D. W., et al. Liver transplantation for hepatocellular carcinoma beyond the Milan criteria: A review. // World J Gastroenterol 2016; 22(12): 3325–3334.Mazzaferro V., et al. Liver transplantation for hepatocellular carcinoma. // Annals of Surgical Oncology 15(4):1001–1007.Mazzaferro V., et al. Liver transplantation for hepatocellular carcinoma. // Annals of Surgical Oncology 15(4):1001–1007.Chapman WC, et al. Outcomes of neoadjuvant transarterial chemoembolization to downstage hepatocellular carcinoma before liver transplantation. // Ann Surg 2008; 248: 617–625.Chapman WC, et al. Outcomes of neoadjuvant transarterial chemoembolization to downstage hepatocellular carcinoma before liver transplantation. // Ann Surg 2008; 248: 617–625.Yao FY, et al. Excellent outcome following down-staging of hepatocellular carcinoma prior to liver transplantation: an intention-to-treat analysis. // Hepatology 2008; 48: 819–827.Yao FY, et al. Excellent outcome following down-staging of hepatocellular carcinoma prior to liver transplantation: an intention-to-treat analysis. // Hepatology 2008; 48: 819–827.Vagefi PA, Hirose R. Downstaging of hepatocellular carcinoma prior to liver transplant: is there a role for adjuvant Sorafenib in locoregional therapy? // J Gastrointest Canc (2010) 41:217–220.Vagefi PA, Hirose R. Downstaging of hepatocellular carcinoma prior to liver transplant: is there a role for adjuvant Sorafenib in locoregional therapy? // J Gastrointest Canc (2010) 41:217–220.Yoo EJ, et al. Orthotopic liver transplantation after the combined use of locoregional therapy and sorafenib for advanced hepatocellular carcinoma. OncoTargets and Therapy 2013:6 755–759.Yoo EJ, et al. Orthotopic liver transplantation after the combined use of locoregional therapy and sorafenib for advanced hepatocellular carcinoma. OncoTargets and Therapy 2013:6 755–759.Bhardwaj N., et al. Current treatment approaches to HCC with a special consideration to transplantation. // Journal of Transplantation Volume 2016, Article ID7926264, 9 pages.Bhardwaj N., et al. Current treatment approaches to HCC with a special consideration to transplantation. // Journal of Transplantation Volume 2016, Article ID7926264, 9 pages.

The authors declare that there are no conflicts of interest present.