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Page 6 of 9 Pasini et al. Hepatoma Res 2020;6:26 I http://dx.doi.org/10.20517/2394-5079.2019.47

TACE
Patients with deteriorated liver function can be treated with TACE. Patients planned for LT should also be
considered for TACE as bridging.

SLT
Patients with decompensated liver function, severe portal hypertension and single or even multiple liver
recurrences, but still fulfilling LT criteria, may be referred for SLT.

Systemic therapies
In the setting of rHCC not amenable to other treatments due to disease that is far too advanced, systemic
therapies can be employed in selected cases.

CONCLUSION
Recurrent HCC may occur after liver resection in up to 80% of cases. A standardized treatment algorithm
for rHCC does not exist but surgical resection should be attempted whenever possible, since it may provide
favourable long-term outcomes with acceptable perioperative risk comparable to primary resection. In
experienced hands, laparoscopic liver resection for both primary and recurrent HCC should be considered.
LT should be considered in all cases where surgical resection cannot be performed, especially in the
context of underlying cirrhosis, if conventional transplantation criteria are met. The use of RFA or TACE as
a bridge to LT, or for palliation represent alternatives for these patients.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception of the paper, reviewed the literature and drafted the
manuscript; equally contributed to the work: Pasini F, Serenari M
Supervised the work, reviewed the manuscript, provided technical support and expert guidance: Cucchetti
A, Ercolani G

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.

REFERENCES
1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and
mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424.