Invited Critique |

Impact of Histological Grade of Hepatocellular Carcinoma on the Outcome of Liver Transplantation—Invited Critique

Robert Rick Selby, MD
Arch Surg. 2001;136(1):31. doi:10.1001/archsurg.136.1.31.
Text Size: A A A
Published online


Hepatocellular cancer is increasingly common in the age of chronic hepatitis B and C. Because of residual chronic hepatitis and tendency of tumor recurrence in the native liver, transplantation rather than hepatic resection is more likely to result in a successful outcome. Certain tumor descriptors exist that allow us to preoperatively stage tumors and assess the potential for recurrence following transplantation. Typically these descriptors include size, number of lesions, bilobar disease, macroscopic intrahepatic vascular invasion (into portal or hepatic venous radicals visible on contrast computed tomographic scanning), capsular invasion with local extension, and nodal or distant disease. All of this information can usually be obtained with the noninvasive high-quality imaging now available. Actual microvascular invasion can only be seen on the explanted specimen, so it is not available to factor into the preoperative decision making. However, microvascular invasion by itself can only result in a stage III designation—a stage that is not a contraindication for transplantation.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles