Locoregional radiological treatment for hepatocellular carcinoma; Which, when and how?

Meza–Junco, Judith; Montano‐Loza, Aldo J.; Liu, David M.; Sawyer, Michael B.; Bain, Vincent G.; Ma, Mang; Owen, Richard

doi:10.1016/j.ctrv.2011.05.002

Cited by 58 publications

(51 citation statements)

References 59 publications

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“…The treatment modalities for HCC included liver transplantation [2,3] , liver resection [4] , local ablation [5] , transcatheter arterial chemoembolization (TACE) [6,7] , molecular target therapy [8,9] , radiotherapy [10] , chemotherapy [11] , and so on. According to Barcelona Clinic Liver Cancer (BCLC) classification, HCC can only be cured by liver transplantation, liver resection, and radiofrequency ablation (RFA) in the very early and early stages of the disease [12] .…”

Section: Introductionmentioning

confidence: 99%

Cell-mediated immunotherapy for hepatocellular carcinoma

Lee¹

2017

JCMT

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Section: Introductionmentioning

confidence: 99%

Cell-mediated immunotherapy for hepatocellular carcinoma

Lee¹

2017

JCMT

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“…Percutaneous ethanol injection should be reserved for cases in which RFA is not technically possible (pericholecystic lesions or lesions near the hepatic hilum). 11 For patients with intermediate-stage HCC, TACE is the standard treatment; however, radioembolization also has a role in treatment. The liver receives blood from the portal vein and hepatic artery at a ratio of 3:1 in the normal liver.…”

Section: Percutaneous Ablationmentioning

confidence: 99%

Untitled

Boyvat

2017

Exp Clin Transplant

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The current treatment modalities for patients with hepatocellular carcinoma are discussed in this review. Hepatocellular carcinoma arises in up to 90% of cirrhotic patients, mainly due to chronic viral hepatitis and alcohol abuse. Nearly two-thirds of all patients with hepatocellular carcinoma are diagnosed at advanced stages, thus causing problems with treatment. Regardless of the stage of the disease, interventional radiology offers both curative and palliative treatment options in the management of this disease. Selecting the most appropriate treatment requires an initial staging assessment and detailed clinical and radiologic workup. Treatment allocation is based on liver function, size and number of tumors, macrovascular invasion, and extrahepatic spread of disease.

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“…The chemotherapeutic agents most commonly used are cis-platinum and doxorubicin mixed as an emulsion with lipiodol, an oily radio-opaque contrast agent concentrated in the tumor and that promotes the exposure of neoplastic cells to the drugs. This emulsion is distributed in the affected segments or lobes and selectively infused in the tumor [99] . Survival rates are 82%, 47% and 26% at 1, 3 and 5 years, respectively.…”

Section: Intermediate Stage (Bclc B)mentioning

confidence: 99%

“…The available data is sufficient to conclude that RFA significantly improves survival and decreases local recurrence when compared to PEI. PEI use should be limited to circumstances when RFA is unavailable or technically not possible [99,100] .…”

Section: Early Stage (Bclc A)mentioning

confidence: 99%

“…They must be very carefully evaluated and in most cases, locoregional therapies are not an option since they can lead to the development of severe and even fatal adverse effects [99] . Another application of intra-arterial embolization is in patients in an early HCC stage and in whom ablation therapy is precluded due to the tumor's location (close to the gallbladder, main bile ducts or main portal vein branches) or other contraindications.…”

Section: Terminal Stage (Bclc D)mentioning

confidence: 99%

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Diagnosis and treatment of hepatocellular carcinoma: An update

Tejeda-Maldonado¹

2015

WJH

110

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Hepatocellular carcinoma (HCC) is one of the most common malignancies leading to high mortality rates in the general population; in cirrhotic patients, it is the primary cause of death. The diagnosis is usually delayed in spite of at-risk population screening recommendations, i.e., patients infected with hepatitis B or C virus. Hepatocarcinogenesis hinges on a great number of genetic and molecular abnormalities that lead to tumor angiogenesis and foster their dissemination potential. The diagnosis is mainly based on imaging studies such as computed tomography and magnetic resonance, in which lesions present a characteristic classical pattern of early arterial enhancement followed by contrast medium "washout" in late venous phase. On occasion, when imaging studies are not conclusive, biopsy of the lesion must be performed to establish the diagnosis. The Barcelona Clinic Liver Cancer staging method is the most frequently used worldwide and recommended by the international guidelines of HCC management. Currently available treatments include tumor resection, liver transplant, sorafenib and locoregional therapies (alcoholization, radiofrequency ablation, chemoembolization). The prognosis of hepatocarcinoma is determined according to the lesion's stage and in cirrhotic patients, on residual liver function. Curative treatments, such as liver transplant, are sought in patients diagnosed in early stages; patients in more advanced stages, were not greatly benefitted by chemotherapy in terms of survival until the advent of target molecules such as sorafenib. Core tip: This paper reviews the most recent evidence on hepatocarcinoma including its molecular pathogenesis and prognosis, with special emphasis on its diagnosis, staging and treatment. The most recent Easter and Western international guidelines are also reviewed.

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Locoregional radiological treatment for hepatocellular carcinoma; Which, when and how?

Cited by 58 publications

References 59 publications

Cell-mediated immunotherapy for hepatocellular carcinoma

Cell-mediated immunotherapy for hepatocellular carcinoma

Untitled

Diagnosis and treatment of hepatocellular carcinoma: An update

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