الفهرس 
SURGICAL PATHOLOGY OFOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer. It occurs approximately 85% of the time in patients who have cirrhosis, the more frequent causes of the associated cirrhosis include chronis hepatitis B&C.
HCC frequently is diagnosed late in its course because of the absence of pathognomonic symptoms and the liver’s large functional reserve. Detection of early-stage HCC in the cirrhotic liver is a challenging task. Advances in imaging modalities have greatly improved the detection of small nodules in part by focusing on the idea of cancerogenesis as a process leading to HCC.
Despite recent advances in other curative treatment options surgical resection remains the mainstay of curative treatment for HCC because of limited availability of liver grafts and limitation of tumor size amenable to ablation therapy.
Liver transplantation also appears to be an ideal treatment for unresectable hepatocellular carcinoma (HCC), since it provides the potential for cure of both the HCC and the underlying liver disease.
Although the early results of liver transplantation for HCC were disappointing, emerging Milan criteria in 1996 improved the outcome of liver transplantation for HCC as same as that for the other liver diseases.
LDLT has been developed as an alternative to DDLT, to improve the organ shortage worldwide. The recent development of LDLT in adults has allowed timely grafting for HCC patients. As a result, LDLT for HCC can achieve an acceptable outcome, which is comparable to the outcome of DDLT for HCC. However, the higher recurrence rates of HCC in LDLT recipients compared to that in DDLT recipients has been shown. It should be verified whether this is contributed to confounding by more advanced disease in LDLT recipients.
Recently, the expansion of the criteria for LDLT for HCC has been proposed from many centers. Validation of the novel criteria, verified and selected from those criteria, will be a major advance in indications for liver transplantation for HCC.
The mismatch between the large number of patients waiting for a transplant and the limited availability of donors has led to numerous ethical and moral issues. Because of the limited number of cadaveric organs, the ethical principal of equity looms large in the allocation of this scarce resource.
New techniques as Stem cell transplantation are under investigation. In the future, these new techniques will improve number of patients in ways we cannot visualise yet.