Diagnosis and Treatment of Hepatocellular Carcinoma

El–Serag, Hashem B.; Marrero, Jorge A.; Rudolph, Linda; Reddy, K. Rajender

doi:10.1053/j.gastro.2008.02.090

Cited by 1,003 publications

(789 citation statements)

References 104 publications

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“…The most reliable diagnostic tests are triple-phase, helical CT and triplephase, dynamic, contrast-enhanced MRI, whereas hepatic angiography or angioassisted CT [CT hepatic arteriography (CTHA) and CT during arterial portography (CTAP)] has fallen out of favor in most practice settings except in Japan [198,199]. The evaluation of blood supply in a hepatocellular nodule is extremely important to characterize the lesion because there are sequential changes in the supplying vessels and hemodynamic state during hepatocarcinogenesis [200].…”

Section: Ct Mri and Other Imaging Modalitiesmentioning

confidence: 99%

“…In addition, according to the guidelines published by the Japan Society of Hepatology [224], hepatectomy or TACE is recommended if there are two or three tumors of less than 3-cm diameter, and TACE or hepatic arterial infusion chemotherapy is recommended if there are more than four tumors. In addition, TACE can be performed in patients at the early stage in whom RFA cannot be performed because of tumor location (proximity to a gallbladder, biliary tree, or blood vessel) or medical comorbidities [198]. TACE is also the first-line therapy for downstaging tumors that exceed the criteria for transplantation [336][337][338].…”

Section: Transarterial Chemoembolizationmentioning

confidence: 99%

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Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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Section: Ct Mri and Other Imaging Modalitiesmentioning

confidence: 99%

Section: Transarterial Chemoembolizationmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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“…[2][3][4] Cirrhosis is present in approximately 90% of HCC cases. The incidence of HCC has increased substantially in several parts of the world because chronic HCV and HBV infections have become more common.…”

Section: Rationale For Advocating Liver Transplantation For Hccmentioning

confidence: 99%

Toward optimizing the indications for orthotopic liver transplantation in hepatocellular carcinoma

Samuel

Colombo²,

El-Serag

et al. 2011

Liver Transpl

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“…1 Unfortunately, the incidence and mortality associated with HCC is increasing steadily in the United States and Europe. 2,3 Current curative options, such as hepatic resection, liver transplantation and local ablative therapies, can be applied to a minority of patients in referral medical institutions. 4,5 Thus, in the majority of advanced HCC cases the prognosis is dismal because of underlying cirrhosis and poor tumor response to chemotherapeutic agents.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Thus, in the majority of advanced HCC cases the prognosis is dismal because of underlying cirrhosis and poor tumor response to chemotherapeutic agents. 3 Recently, treatment with sorafenib in patients with advanced disease increased their median survival from 7.9 to 10.7 months when compared with patients receiving placebo, despite objective responses were only found in 2% of sorafenib-treated patients. 6 Therefore, new therapeutic options are urgently needed for the treatment of advanced HCC.…”

Section: Introductionmentioning

confidence: 99%

A phase I clinical trial of thymidine kinase-based gene therapy in advanced hepatocellular carcinoma

et al. 2010

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The aim of this phase I clinical trial was to assess the feasibility and safety of intratumoral administration of a first-generation adenoviral vector encoding herpes simplex virus thymidine kinase (HSV-TK) gene (Ad.TK) followed by systemic ganciclovir to patients with advanced hepatocellular carcinoma (HCC). Secondarily, we have analyzed its antitumor effect. Ten patients were enrolled in five dose-level cohorts that received from 10 10 to 2 Â 10 12 viral particles (vp). Ad.TK was injected intratumorally and patients received up to three doses at 30-day intervals. Positron emission tomography was used to monitor TK gene expression. Ad.TK injection was feasible in 100% of cases. Treatment was well tolerated and dose-limiting toxicity was not achieved. Cumulative toxicity was not observed. Hepatic toxicity was absent even in cirrhotic patients. Fever, flu-like syndrome, pain at the injection site and pancytopenia were the most common side effects. No partial responses were observed and 60% of patients showed tumor stabilization of the injected lesion. Importantly, two patients who received the highest dose showed signs of intratumoral necrosis by imaging procedures. One of them achieved a sustained stabilization and survived for 26 months. In conclusion, Ad.TK can be safely administered by intratumoral injection to patients with HCC up to 2 Â 10 12 vp per patient.

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Diagnosis and Treatment of Hepatocellular Carcinoma

Cited by 1,003 publications

References 104 publications

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Toward optimizing the indications for orthotopic liver transplantation in hepatocellular carcinoma

A phase I clinical trial of thymidine kinase-based gene therapy in advanced hepatocellular carcinoma

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