Hepatocellualr cancer and liver transplantation: from the tower of babel towards a uniform language

Until the end of the twentieth century, patients with liver cancer were almost exclusively being taken care of in surgical departments implementing in a minority of patients partial or total liver resections. As up to 95% of liver cancers arise in the context of an underlying liver disease, aggressive treatment (this means liver transplantation) was advocated, as this procedure indeed deals with both conditions, the cancer and the underlying liver disease. Th. E. Starzl, the father of modern transplantation, designed in the late fifties this intervention to cure (both primary and secondary!) liver malignancies. Therefore, expertise about care and treatment of liver cancer remained concentrated for almost half a century in liver transplant centers and in oncologic groups working in close collaboration with liver transplant centers.