Salvage liver transplantation for the treatment of recurrent liver cancer after hepatectomy        CHEN Hao, PENG Cheng-hong. Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200025, China
Corresponding author: PENG Cheng-hong, E-mail: chhpeng@188.com
Abstract    Hepatectomy is the mainstay of treatment for hepatocellular carcinoma (HCC) though higher rate of recurrence exists. Liver transplantation is the treatment option for patients with unresectable tumors associated with hepatic malfunction. However, some authors have advocated salvage liver transplantation even for the recurrence of HCC after hepatectomy due to shortage of donor. The first choice of primary hepatectomy or liver transplantation has been argued for recent years. Milan criteria have been obeyed for the performance of salvage transplantation in the most of transplant centers. Only small part of patients have chance to receive salvage transplantation after the recurrence of HCC. Many retrospective investigation or studies of intention-to-treat analysis have revealed that there was similar rate of long survival between primary liver transplantation and salvage transplantation. However, such result has not been confirmed by the data from prospective studies. The consensus is that primary hepatectomy for HCC should be chosen for elder patients associated with good liver function and salvage transplantation could be performed when recurrence occurs.