medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-20-110-116medsovet-6587Research ArticleОПУХОЛИ ПЕЧЕНИLIVER TUMORSНеоадъювантная терапия в режиме ожидания трансплантации печени при гепатоцеллюлярном ракеNeoadjuvant therapy bridging patients with hepatocellular cancer waiting for liver transplanthttps://orcid.org/0000-0002-5183-1555ПиткевичМ. Ю.PitkevichA. A.

аспирант, 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Postgraduate Student, 

8, Bldg. 2, Trubetskaya St., Moscow, 119991

m.u.pitkevich@gmail.comhttps://orcid.org/0000-0002-3083-2102КосыревВ. Ю.KosyrevV. Yu.

д.м.н., ведущий научный сотрудник отделения рентгенохирургических методов диагностики и лечения, ведущий научный сотрудник отделения интервенционной радиологии, 115478, Москва, Каширское шоссе, д. 24;

доцент кафедры онкологии, 119991, Москва, ул. Трубецкая, д. 8, стр. 2

 

Dr. Sci. (Med.), Lead Reasearch Associate, X-ray Surgical Diagnostics and Treatment Department, Lead Reasearch Associate, Department of Interventional Radiology, 24, Kashirskoye Shosse, Moscow, 115478;

Associate Professor of Oncology Department, 8, Bldg. 2, Trubetskaya St., Moscow, 119991

 

vkosirev@mail.ruhttps://orcid.org/0000-0002-6323-511XДжанянИ. А.DzhanyanI. A.

врач-хирург отделения химиотерапии №17, 

115478, Москва, Каширское шоссе, д. 24

Surgeon of Chemotherapy Department No.17, 

24, Kashirskoye Shosse, Moscow, 115478

i-dzhanyan@mail.ruhttps://orcid.org/0000-0002-6362-7914НоврузбековМ. С.NovruzbekovM. S.

д.м.н., заведующий научным отделением трансплантации печени, 

129090, Москва, Б. Сухаревская пл., д. 3, стр. 21

Dr. Sci. (Med.), Head of Liver Transplant Research Department, 

3, Bldg. 21, B. Sukharevskaya Square, Moscow, 129090

n.m.s@bk.ruhttps://orcid.org/0000-0002-3537-6601МонаховА. Р.MonakhovA. R.

к.м.н., заведующий хирургическим отделением №2 (трансплантация печени), доцент кафедры трансплантологии и искусственных органов,

123182, Москва, Щукинская ул., д. 1

Cand. Sci. (Med.), Head of Surgical Department No.2 (liver transplant), Associate Professor of Department of Transplantology and Artificial Organs,

1, Shchukinskaya St., Moscow, 123182

a.r.monakhov@gmail.comhttps://orcid.org/0000-0001-5436-7092ЗубенкоС. И.ZubenkoS. I.

врач-хирург хирургического отделения №2, 

123182, Москва, Щукинская ул., д. 1

Surgeon of Surgical Department No.2, 

1, Shchukinskaya St., Moscow, 123182

zubenko_translp@yahoo.comhttps://orcid.org/0000-0001-5691-5398ВосканянС. Э.VoskanyanS. E.

чл.- корр. РАН, д.м.н., профессор, заместитель главного врача по хирургической помощи – руководитель, 123098, Москва, ул. Маршала Новикова, д. 23;

заведующий кафедрой хирургии с курсами онкохирургии, эндоскопии, хирургической патологии, клинической трансплантологии и органного донорства, 123098, Москва, ул. Живописная, д. 46, с. 8

Dr. Sci. (Med.), Corr. Member of RAS, Professor, Deputy Chief Physician for Surgical Care - Head, 23, Marshal Novikov St., Moscow, 123098;

Head of Department of Surgery with Courses in Oncosurgery, Endoscopy, Surgical Pathology, 46, Bldg. 8, Zhivopisnaya St.,Moscow, 123098

https://orcid.org/0000-0002-3171-6621РудаковВ. С.RudakovV. S.

к.м.н., врач-хирург хирургического отделения по координации донорских органов и (или) тканей человека,

123098, Москва, ул. Маршала Новикова, д. 23

Cand. Sci. (Med.), Surgeon of Surgical Department for Coordination of Human Organs and (or) Tissues Procurement, 

23, Marshal Novikov St., Moscow, 123098

rudakov_vc@list.ruhttps://orcid.org/0000-0003-3565-4058МорозЕ. А.MorozE. A.

к.м.н., старший научный сотрудник отдела патологической анатомии опухолей человека, 

115478, Москва, Каширское шоссе, д. 24

Cand. Sci. (Med.), Senior Research Associate, Division of Pathological Anatomy of Human Tumours, 

24, Kashirskoye Shosse, Moscow, 115478

moroz-kate@yandex.ruhttps://orcid.org/0000-0002-6244-4294БредерВ. В.BrederV. V.

д.м.н., ведущий научный сотрудник отделения химиотерапии №17, 

115478, Москва, Каширское шоссе, д. 24

Dr. Sci. (Med.), Lead Research Associate, Chemotherapy Department No.17, 

24, Kashirskoye Shosse, Moscow, 115478

vbreder@yandex.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. Блохина; Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияBlokhin National Medical Research Center of Oncology; Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. БлохинаРоссияBlokhin National Medical Research Center of OncologyRussian FederationНаучно-исследовательский институт скорой помощи имени. Н.В. СклифосовскогоРоссияResearch Institute of Emergency Medical Care named after N.V. SklifosovskyRussian FederationФедеральный научный центр трансплантологии и искусственных органов имени академика В.И. ШумаковаРоссияFederal Scientific Center for Transplantology and Artificial Organs named after Academician V.I. ShumakovRussian FederationФедеральный научный центр трансплантологии и искусственных органов имени академика В.И. ШумаковаРоссияFederal Scientific Center for Transplantology and Artificial Organs named after Academician V.I. ShumakovRussian FederationЦентр хирургии и трансплантологии, Федеральный медицинский биофизический центр имени А.И. Бурназяна; Медико-биологический университет инноваций и непрерывного образования, Федеральный медицинский биофизический центр имени А.И. БурназянаРоссияBurnazyan Federal Medical Biophysical Center; Clinical Transplantology and Organ Donation, Burnazyan Federal Medical Biophysical CenterRussian FederationЦентр хирургии и трансплантологии, Федеральный медицинский биофизический центр имени А.И. БурназянаРоссияCenter for Surgery and Transplantology, Burnazyan Federal Medical Biophysical CenterRussian Federation202110122021020110116Copyright © Питкевич М.Ю., Косырев В.Ю., Джанян И.А., Новрузбеков М.С., Монахов А.Р., Зубенко С.И., Восканян С.Э., Рудаков В.С., Мороз Е.А., Бредер В.В., 20212021Питкевич М.Ю., Косырев В.Ю., Джанян И.А., Новрузбеков М.С., Монахов А.Р., Зубенко С.И., Восканян С.Э., Рудаков В.С., Мороз Е.А., Бредер В.В.Pitkevich A.A., Kosyrev V.Y., Dzhanyan I.A., Novruzbekov M.S., Monakhov A.R., Zubenko S.I., Voskanyan S.E., Rudakov V.S., Moroz E.A., Breder V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6587Введение

Введение. Трансплантация печени (ТП) является признанным методом лечения гепатоцеллюлярной карциномы (ГЦК). Роль неоадъювантной терапии (НАТ) остается спорной.

Целью данной работы является оценка влияния НАТ на безрецидивную выживаемость (БРВ) и общую выживаемость (ОВ) пациентов с ГЦК, перенесших ТП.

Материалы и методы

Материалы и методы. С октября 2010 г. по январь 2020 г. в Национальном медицинском исследовательском центре онкологии имени Н.Н. Блохина наблюдалось 63  пациента с  диагнозом ГЦК. Из  них 28  пациентов не  получали никого типа лечения до трансплантации, 35 пациентов получали различные виды НАТ. Исходные характеристики опухоли и пациента были сопоставимы между двумя группами. В группе пациентов без НАТ наблюдалось значительное количество больных с декомпенсированным циррозом печени (n = 14; 50%), в то время как в группе пациентов без НАТ пациентов с циррозом печени СР-С не наблюдалось (n = 0; 0%; p = 0,000). Среднее время ожидания трансплантации печени составило 10,3 мес. в группе НАТ и 6,8 мес. в группе без НАТ (p = 0,561).

Результаты

Результаты. В подгруппе bridge-терапии прогрессирование опухолевого процесса было выявлено у 29% больных, стабилизация заболевания – у 47% больных, частичного ответа удалось достигнуть у 14% больных, полный опухолевый ответ наблюдался у 5%, не удалось оценить эффект проведенной терапии у 5% пациентов в связи с отсутствием необходимых данных в архиве. В подгруппе down-staging терапии прогрессирование опухолевого процесса было выявлено у 23% больных, стабилизация заболевания – у 41% больных, частичного ответа удалось достигнуть у 12% больных, полный опухолевый ответ наблюдался у 6%, 18% пациентов удалось перевести в рамки Миланских критериев.

Выводы

Выводы. При сравнении групп НАТ и контрольной группы не было различий в общей выживаемости (ОВ) или выживаемости без болезней (ВБП). 

Introduction

Introduction. Liver transplant (LT) is a widely accepted treatment for hepatocellular carcinoma (HCC). The role of neoadjuvant (NAT) is still under debate.

The aim of the work is to assess the effect of NAT on relapse-free survival (RFS) and overall survival (OS) in patients with HCC who underwent LT.

Methods and materials

Methods and materials. 63 patients diagnosed with HCC were observed at Blokhin National Medical Research Center of Oncology from October 2010 to January 2020. Of these, 28 patients did not receive any type of treatment before transplantation, 35 patients received various types of NAT. Two groups had similar patient and tumour characteristics at baseline. A significant number of patients with decompensated cirrhosis were observed in the non-NAT group (n = 14; 50%), while no patients with CP-C liver cirrhosis were observed in the NAT group (n = 0; 0%; p = 0.000). The average wait for a liver transplant was 10.3 months in the NAT group and 6.8 months in the NAT-free group (p = 0.561).

Results

Results. In the bridging subgroup, the tumour progression was detected in 29% of patients, stable disease in 47% of patients, partial response was achieved in 14% of patients, complete tumour response was observed in 5%. For 5% of patients, it was not possible to estimate the effect of the therapy due to the lack of appropriate data archives. In the subgroup of downstaging therapy, the tumour progression was detected in 23% of patients, stable disease in 41% of patients, a partial response was achieved in 12% of patients, a complete tumour response was observed in 6%. The treatment allowed the Milan criteria to be fulfilled in 18% of patients.

Conclusion

Conclusion. There was no difference in overall survival (OS) or disease-free survival (DFS) between the NAT and control groups. 

гепатоцеллюлярный рактрансплантация печенинеоадъювантная терапияТАХЭРЧАhepatocellular cancerliver transplantationneoadjuvant therapyTACERFAReferencesBray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018;68(6):394–424. https://doi.org/10.3322/caac.21492.Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018;68(6):394–424. https://doi.org/10.3322/caac.21492.Marengo A., Rosso C,. Bugianesi E. Liver cancer: connections with obesity, fatty liver, and cirrhosis. Annu Rev Med. 2016;67:103–117. https://doi.org/10.1146/annurev-med-090514-013832.Marengo A., Rosso C,. Bugianesi E. Liver cancer: connections with obesity, fatty liver, and cirrhosis. Annu Rev Med. 2016;67:103–117. https://doi.org/10.1146/annurev-med-090514-013832.Chang M.-H., Chen C.-J., Lai M.-S., Hsu H.-M., Wu T.-C., Kong M.-Sh. et al. Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. N Engl J Med. 1997;336(26):1855–1859. https://doi.org/10.1056/nejm199706263362602.Chang M.-H., Chen C.-J., Lai M.-S., Hsu H.-M., Wu T.-C., Kong M.-Sh. et al. Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. N Engl J Med. 1997;336(26):1855–1859. https://doi.org/10.1056/nejm199706263362602.Thursz M., Fontanet A. HCV transmission in industrialized countries and resource-constrained areas. Nat Rev Gastroenterol Hepatol. 2014;11(1):28–35. https://doi.org/10.1038/nrgastro.2013.179.Thursz M., Fontanet A. HCV transmission in industrialized countries and resource-constrained areas. Nat Rev Gastroenterol Hepatol. 2014;11(1):28–35. https://doi.org/10.1038/nrgastro.2013.179.European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;48(5):599–641. https://doi.org/10.1016/j.ejca.2011.12.021.European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;48(5):599–641. https://doi.org/10.1016/j.ejca.2011.12.021.Lang H., Sotiropoulos G.C., Dömland M., Frühauf N.R., Paul A., Hüsing J. et al. Liver resection for hepatocellular carcinoma in non-cirrhotic liver without underlying viral hepatitis. Brit J Surg. 2005;92(2):198–202. https://doi.org/10.1002/bjs.4763.Lang H., Sotiropoulos G.C., Dömland M., Frühauf N.R., Paul A., Hüsing J. et al. Liver resection for hepatocellular carcinoma in non-cirrhotic liver without underlying viral hepatitis. Brit J Surg. 2005;92(2):198–202. https://doi.org/10.1002/bjs.4763.Santambrogio R., Kluger M.D., Costa M., Belli A., Barabino M., Laurentet A. et al. Hepatic resection for hepatocellular carcinoma in patients with Child-Pugh’s A cirrhosis: is clinical evidence of portal hypertension a contraindication? HPB. 2013;15(1):78–84. https://doi.org/10.1111/j.1477-2574.2012.00594.x.Santambrogio R., Kluger M.D., Costa M., Belli A., Barabino M., Laurentet A. et al. Hepatic resection for hepatocellular carcinoma in patients with Child-Pugh’s A cirrhosis: is clinical evidence of portal hypertension a contraindication? HPB. 2013;15(1):78–84. https://doi.org/10.1111/j.1477-2574.2012.00594.x.Ercolani G., Grazi G.L., Ravaioli M., Gaudio M.D., Gardini A., Cescon M. et al. Liver resection for hepatocellular carcinoma on cirrhosis: univariate and multivariate analysis of risk factors for intrahepatic recurrence. Ann Surg. 2003;237(4):536–543. https://doi.org/10.1097/01.sla.0000059988.22416.f2.Ercolani G., Grazi G.L., Ravaioli M., Gaudio M.D., Gardini A., Cescon M. et al. Liver resection for hepatocellular carcinoma on cirrhosis: univariate and multivariate analysis of risk factors for intrahepatic recurrence. Ann Surg. 2003;237(4):536–543. https://doi.org/10.1097/01.sla.0000059988.22416.f2.Wayne J.D., Gregory Y.L., Ikai I., Dorota A.D., Belghiti J., Yamaoka Y. et al. Preoperative predictors of survival after resectionn of small hepatocellular carcinomas. Ann Surg. 2002;235(5):722–730. https://doi.org/10.1097/00000658-200205000-00015.Wayne J.D., Gregory Y.L., Ikai I., Dorota A.D., Belghiti J., Yamaoka Y. et al. Preoperative predictors of survival after resectionn of small hepatocellular carcinomas. Ann Surg. 2002;235(5):722–730. https://doi.org/10.1097/00000658-200205000-00015.Zheng Z., Liang W., Milgrom D.P., Zheng Z., Schroder P.M., Kong N.S. et al. Liver transplantation versus liver resection in the treatment of hepatocellular carcinoma: a meta-analysis of observational studies. Transplantation. 2014;97(2):227–234. https://doi.org/10.1097/tp.0b013e3182a89383.Zheng Z., Liang W., Milgrom D.P., Zheng Z., Schroder P.M., Kong N.S. et al. Liver transplantation versus liver resection in the treatment of hepatocellular carcinoma: a meta-analysis of observational studies. Transplantation. 2014;97(2):227–234. https://doi.org/10.1097/tp.0b013e3182a89383.Tanaka S., Iimuro Yu., Hirano T., Hai S., Suzumura K., Nakamura I. et al. Safety of hepatic resection for hepatocellular carcinoma in obese patients with cirrhosis. Surg Today. 2013;43(11):1290–1297. https://doi.org/10.1007/s00595-013-0706-2.Tanaka S., Iimuro Yu., Hirano T., Hai S., Suzumura K., Nakamura I. et al. Safety of hepatic resection for hepatocellular carcinoma in obese patients with cirrhosis. Surg Today. 2013;43(11):1290–1297. https://doi.org/10.1007/s00595-013-0706-2.Kornberg A. Liver transplantation for hepatocellular carcinoma beyond Milan criteria: multidisciplinary approach to improve outcome. ISRN Hepatology. 2014;2014:706945. https://doi.org/10.1155/2014/706945.Kornberg A. Liver transplantation for hepatocellular carcinoma beyond Milan criteria: multidisciplinary approach to improve outcome. ISRN Hepatology. 2014;2014:706945. https://doi.org/10.1155/2014/706945.Lee Y.Ch., Chow P. Liver transplantation for hepatocellular carcinoma: an appraisal of current controversies. Liver Cancer. 2012;1(3–4):183–189. https://doi.org/10.1159/000343832. 14. Bruix J., Sherman M. Management of Hepatocellular Carcinoma: An update. Hepatology. 2011;53(3):1020–1022. https://doi.org/10.1002/hep.24199.Lee Y.Ch., Chow P. Liver transplantation for hepatocellular carcinoma: an appraisal of current controversies. Liver Cancer. 2012;1(3–4):183–189. https://doi.org/10.1159/000343832. 14. Bruix J., Sherman M. Management of Hepatocellular Carcinoma: An update. Hepatology. 2011;53(3):1020–1022. https://doi.org/10.1002/hep.24199.Alba E., Valls C., Dominguez J., Martinez L., Escalante E., Lladó L. et al. Transcatheter arterial chemoembolization in patients with hepatocellular carcinoma on the waiting list for orthotopic liver transplantation. AJR Am J Roentgenol. 2008;190(5):1341–1348. https://doi.org/10.2214/AJR.07.2972.Alba E., Valls C., Dominguez J., Martinez L., Escalante E., Lladó L. et al. Transcatheter arterial chemoembolization in patients with hepatocellular carcinoma on the waiting list for orthotopic liver transplantation. AJR Am J Roentgenol. 2008;190(5):1341–1348. https://doi.org/10.2214/AJR.07.2972.Mazzaferro V., Battiston C., Perrone S., Pulvirenti A., Regalia E., Romito R. et al. Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation: a prospective study. Ann Surg. 2004;240(5):900–909. https://doi.org/10.1097/01.sla.0000143301.56154.95.Mazzaferro V., Battiston C., Perrone S., Pulvirenti A., Regalia E., Romito R. et al. Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation: a prospective study. Ann Surg. 2004;240(5):900–909. https://doi.org/10.1097/01.sla.0000143301.56154.95.Lu D.S., Yu N.C., Raman S.S., Lassman C., Tong M.J., Britten C. et al. Percutaneous radiofrequency ablation of hepatocellular carcinoma as a bridge to liver transplantation. Hepatology. 2005;41(5):1130–1137. https://doi.org/10.1002/hep.20688.Lu D.S., Yu N.C., Raman S.S., Lassman C., Tong M.J., Britten C. et al. Percutaneous radiofrequency ablation of hepatocellular carcinoma as a bridge to liver transplantation. Hepatology. 2005;41(5):1130–1137. https://doi.org/10.1002/hep.20688.Tsochatzis E., Garcovich M., Marelli L., Papastergiou V., Fatourou E., Rodriguez-Peralvarez M.L. et al. Transarterial embolization as neo-adjuvant therapy pretransplantation in patients with hepatocellular carcinoma. Liver Int. 2013;33(6):944–949. https://doi.org/10.1111/liv.12144.Tsochatzis E., Garcovich M., Marelli L., Papastergiou V., Fatourou E., Rodriguez-Peralvarez M.L. et al. Transarterial embolization as neo-adjuvant therapy pretransplantation in patients with hepatocellular carcinoma. Liver Int. 2013;33(6):944–949. https://doi.org/10.1111/liv.12144.Freeman R.B., Steffick D.E., Guidinger M.K., Farmer D.G., Berg C.L., Merion R.M. Liver and intestine transplantation in the United States, 1997-2006. Am J Transplant. 2008;8(4 Pt 2):958–976. https://doi.org/10.1111/j.1600-6143.2008.02174.x.Freeman R.B., Steffick D.E., Guidinger M.K., Farmer D.G., Berg C.L., Merion R.M. Liver and intestine transplantation in the United States, 1997-2006. Am J Transplant. 2008;8(4 Pt 2):958–976. https://doi.org/10.1111/j.1600-6143.2008.02174.x.Lai Q., Avolio A.W., Graziadei I., Otto G., Rossi M., Tisone G. et al. Alphafetoprotein and modified response evaluation criteria in solid tumors progression after locoregional therapy as predictors of hepatocellular cancer recurrence and death after transplantation. Liver Transpl. 2013;19(10):1108–1118. https://doi.org/10.1002/lt.23706.Lai Q., Avolio A.W., Graziadei I., Otto G., Rossi M., Tisone G. et al. Alphafetoprotein and modified response evaluation criteria in solid tumors progression after locoregional therapy as predictors of hepatocellular cancer recurrence and death after transplantation. Liver Transpl. 2013;19(10):1108–1118. https://doi.org/10.1002/lt.23706.Yao F.Y., Kerlan R.K., Hirose R., Davern T.J., Bass N.M., Feng S et al. Excellent outcome following down-staging of hepatocellular carcinoma prior to liver transplantation: an intention-to-treat analysis. Hepatology. 2008;48(3):819–827. https://doi.org/10.1002/hep.22412.Yao F.Y., Kerlan R.K., Hirose R., Davern T.J., Bass N.M., Feng S et al. Excellent outcome following down-staging of hepatocellular carcinoma prior to liver transplantation: an intention-to-treat analysis. Hepatology. 2008;48(3):819–827. https://doi.org/10.1002/hep.22412.De Carlis L., Di Sandro S., Giacomoni A., Slim A., Lauterio A., Mangoni I. et al. Beyond the Milan criteria: what risks for patients with hepatocellular carcinoma progression before liver transplantation? J Clin Gastroenterol. 2012;46(1):78–86. https://doi.org/10.1097/mcg.0b013e31822b36f6.De Carlis L., Di Sandro S., Giacomoni A., Slim A., Lauterio A., Mangoni I. et al. Beyond the Milan criteria: what risks for patients with hepatocellular carcinoma progression before liver transplantation? J Clin Gastroenterol. 2012;46(1):78–86. https://doi.org/10.1097/mcg.0b013e31822b36f6.Готье С.В., Монахов А.Р., Цирульникова О.М., Зубенко С.И., Ситникова Е.В., Умрик Д.В. и др. Результаты трансплантации печени при гепатоцеллюлярном раке: опыт одного центра. Анналы хирургической гепатологии. 2020;25(2):67–76. https://doi.org/10.16931/1995-5464.2020267-76.Gautier S.V., Monakhov A.R., Tsirulnikova O.M., Zubenko S.I., Sitnikova E.V., Umrik D.V. et al. Outcomes of liver transplantation in hepatocellular carcinoma: a single-center experience. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2020;25(2):67–76. (In Russ.) https://doi.org/10.16931/1995-5464.2020267-76.Otto G., Herber S., Heise M., Lohse A.W., Mönch C., Bittinger F. et al. Response to transarterial chemoembolization as a biological selection criterion for liver transplantation in hepatocellular carcinoma. Liver Transpl. 2006;12(8):1260–1267. https://doi.org/10.1002/lt.20837 .Otto G., Herber S., Heise M., Lohse A.W., Mönch C., Bittinger F. et al. Response to transarterial chemoembolization as a biological selection criterion for liver transplantation in hepatocellular carcinoma. Liver Transpl. 2006;12(8):1260–1267. https://doi.org/10.1002/lt.20837 .Graziadei I.W., Sandmueller H., Waldenberger P., Koenigsrainer A., Nachbaur K., Jaschke W. 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. 2003;9(6):557–563. https://doi.org/10.1053/jlts.2003.50106.Graziadei I.W., Sandmueller H., Waldenberger P., Koenigsrainer A., Nachbaur K., Jaschke W. 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. 2003;9(6):557–563. https://doi.org/10.1053/jlts.2003.50106.Decaens T., Roudot-Thoraval F., Bresson-Hadni S., Meyer C., Gugenheim J., Durand F. et al. Impact of pretransplantation transarterial chemoembolization on survival and recurrence after liver transplantation for hepatocellular carcinoma. Liver Transpl. 2005;11(7):767–775. https://doi.org/10.1002/lt.20418.Decaens T., Roudot-Thoraval F., Bresson-Hadni S., Meyer C., Gugenheim J., Durand F. et al. Impact of pretransplantation transarterial chemoembolization on survival and recurrence after liver transplantation for hepatocellular carcinoma. Liver Transpl. 2005;11(7):767–775. https://doi.org/10.1002/lt.20418.Agopian V.G., Morshedi M.M., McWilliams J., Harlander-Locke M.P., Markovic D., Zarrinpar A. et al. Complete pathologic response to pretransplant locoregional therapy for hepatocellular carcinoma defines cancer cure after liver transplantation: analysis of 501 consecutively treated patients. Ann Surg. 2015;262(3):536–545. https://doi.org/10.1097/sla.0000000000001384.Agopian V.G., Morshedi M.M., McWilliams J., Harlander-Locke M.P., Markovic D., Zarrinpar A. et al. Complete pathologic response to pretransplant locoregional therapy for hepatocellular carcinoma defines cancer cure after liver transplantation: analysis of 501 consecutively treated patients. Ann Surg. 2015;262(3):536–545. https://doi.org/10.1097/sla.0000000000001384.Cescon M., Cucchetti A., Ravaioli M., Pinna AD. Hepatocellular carcinoma locoregional therapies for patients in the waiting list. Impact on transplantability and recurrence rate. J Hepatol. 2013;58(3):609–618. https://doi.org/10.1016/j.jhep.2012.09.021.Cescon M., Cucchetti A., Ravaioli M., Pinna AD. Hepatocellular carcinoma locoregional therapies for patients in the waiting list. Impact on transplantability and recurrence rate. J Hepatol. 2013;58(3):609–618. https://doi.org/10.1016/j.jhep.2012.09.021.Garwood E.R., Fidelman N., Hoch S.E., Kerlan R.K., Yao F.Y. Morbidity and mortality following transarterial liver chemoembolization in patients with hepatocellular carcinoma and synthetic hepatic dysfunction. Liver Transpl. 2013;19(2):164–173. https://doi.org/10.1016/j.jhep.2012.09.021.Garwood E.R., Fidelman N., Hoch S.E., Kerlan R.K., Yao F.Y. Morbidity and mortality following transarterial liver chemoembolization in patients with hepatocellular carcinoma and synthetic hepatic dysfunction. Liver Transpl. 2013;19(2):164–173. https://doi.org/10.1016/j.jhep.2012.09.021.Hsin I.F., Hsu C.Y., Huang H.C., Huang Y.H., Lin H.C., Lee R.C. et al. Liver failure after transarterial chemoembolization for patients with hepatocellular carcinoma and ascites: incidence, risk factors, and prognostic prediction. J Clin Gastroenterol. 2011;45(6):556–562. https://doi.org/10.1097/mcg.0b013e318210ff17.Hsin I.F., Hsu C.Y., Huang H.C., Huang Y.H., Lin H.C., Lee R.C. et al. Liver failure after transarterial chemoembolization for patients with hepatocellular carcinoma and ascites: incidence, risk factors, and prognostic prediction. J Clin Gastroenterol. 2011;45(6):556–562. https://doi.org/10.1097/mcg.0b013e318210ff17.Kothary N., Weintraub J.L., Susman J., Rundback J.H. Transarterial chemoembolization for primary hepatocellular carcinoma in patients at high risk. J Vasc Interv Radiol. 2007;18(12):1517–1526. https://doi.org/10.1016/j. jvir.2007.07.035.Kothary N., Weintraub J.L., Susman J., Rundback J.H. Transarterial chemoembolization for primary hepatocellular carcinoma in patients at high risk. J Vasc Interv Radiol. 2007;18(12):1517–1526. https://doi.org/10.1016/j. jvir.2007.07.035.

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