Transforming Hepatocellular Carcinoma Treatment in Lower Income Countries
Hepatocellular carcinoma (HCC) is the second leading cause of global cancer-related death, and more than 80% of the global burden is borne by lower income countries.1 However, liver transplant (LT) and endovascular or percutaneous tumor destructive treatments provide cure rates approaching 90% at 5 years. Linkage to LT, rather than to chemotherapy, is therefore the standard of care for patients with nonmetastatic HCC, propelling HCC to the fourth leading indication for LT in the United States.2 However in lower income countries, in which the symphony of pretransplant medical optimization, tumor destructive treatments, organ procurement, transplant surgery, and lifelong posttransplant care is lacking, HCC management is often relegated to palliative therapy or no treatment at all.
