Hepatocellular carcinoma locoregional therapies: Outcomes and future horizons

Abstract

Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver and has an overall five-year survival rate of less than twenty percent. For patients with unresectable disease, evolving liver-directed locoregional therapies provide efficacious treatment across the spectrum of disease stages and via a variety of catheter-directed and percutaneous techniques. Goals of locoregional therapies in HCC may include curative intent in early-stage disease, bridging or downstaging to surgical resection or transplantation for early or intermediate-stage disease, and local disease control and palliation in advanced-stage disease. This review explores the outcomes of chemoembolization, bland embolization, radioembolization, and percutaneous ablative therapies. Attention is also given to prognostic factors related to each of the respective techniques, as well as future directions of locoregional therapies for HCC.

Long-Term Comparative Study on the Local Tumour Control of Different Ablation Technologies in Primary and Secondary Liver Malignancies

“…Optimal results can be achieved with primary and secondary liver tumours up to a size of 3 cm. RFA is a classic single-probe procedure [ 1 , 3 , 7 ].…”

“…So-called “keyhole procedures” are constantly evolving and have become an indispensable part of modern medicine [ 1 ]. Today, image-guided local ablative therapies (LAT) expand the therapeutic spectrum in multimodal cancer therapy and open up new dimensions in terms of therapy tolerability and compliance [ 2 ].…”

“…Today, image-guided local ablative therapies (LAT) expand the therapeutic spectrum in multimodal cancer therapy and open up new dimensions in terms of therapy tolerability and compliance [ 2 ]. Local tumour control (LTC) has established itself as an important pillar of modern oncology, complementing systemic chemotherapy (SCT) and surgery [ 1 , 2 , 3 ]. In the oligometastatic setting, patients can be provided long-term disease control and survival benefit if the critical foci of disease are removed.…”

“…Although the safety and effectiveness of the individual procedures have already been sufficiently evaluated, we also know today that not all procedures are equivalent in all situations [ 2 , 7 ]. However, modern personalised medicine requires the individualized use of LAT, adapted to the respective situation in the best possible way [ 1 , 8 ].…”

Advances in Nanoliposomes for the Diagnosis and Treatment of Liver Cancer

“…The staging of HCC is generally performed using the Okuda staging system, the Cancer of the Liver Italian Program, the Hong Kong Liver Cancer (HKLC) staging system, and the Barcelona Clinic Liver Cancer (BCLC) staging system, which is the most popular. 4 The current approach to HCC treatment depends on the stage at which the patient is diagnosed. 5 The BCLC staging system recommends that only patients classified as BCLC stage 0 or A be administered surgical resection or liver transplantation.…”