Multimodal treatment of unresectable hepatocellular carcinoma to achieve complete response results in improved survival

Abstract

This retrospective review of patients treated for intermediate and advanced stage HCC revealed a significant survival advantage in patients who achieved a complete response. These data support use of a multi-modality approach to intermediate and advanced stage HCC, combining liver-directed treatments as necessary to achieve a complete response.

Tailored treatment of patients with hepatocellular carcinoma with portal vein invasion: experience from a multidisciplinary hepatobiliary tumor program within a NCI comprehensive cancer center

“…An American study (21) of 141 patients with locally aggressive HCC including 31 patients with portal vein thrombosis treated with TACE/DEB (transarterial c h e m o t h e r a p y w i t h d r u g -e l u t i n g b e a d s ) o r I A B demonstrated complete radiologic response in 35.9% of patients. This was associated with a significant survival advantage compared to patients with a partial response.…”

“…These historical norms may be changing; a recent Japanese report found 53.3% of patients with HCV infection and only 23.3% with HBV infection (27). Unfortunately the recent major European and American studies of treatment of HCC with PVI do not differentiate between HBV and HCV infection (11,13,21).…”

Computational simulation of the predicted dosimetric impact of adjuvant yttrium-90 PET/CT-guided percutaneous ablation following radioembolization

“…However, this does not suggest that there is no utility in treatment optimization. Response following locoregional hepatic therapy has been shown to correlate with improved patient survival, prompting the use of multimodality therapies [12, 13] to improve tumor response. One such example of multimodality therapy is combined trans-arterial chemoembolization (TACE) and radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC) [12].…”

Developing a liver cancer program in the nonacademic medical center

“…Additionally, the cancer center is the primary access point to research protocols for patients. Finally, this multidisciplinary approach to HCC provides opportunities for community‐based clinical outcomes research …”

“…Finally, this multidisciplinary approach to HCC provides opportunities for communitybased clinical outcomes research. 9 The greatest potential to reduce HCC diagnosis and deaths in the community is primary prevention by identifying and treating hepatitis B and C. Expanding access to viral hepatitis care and increasing treatment capacity is necessary to substantiality impact virally induced HCC in particular. We are actively involved with patient care and legal advocates at the regional and state levels to increase access to curative direct-acting antivirals for viral hepatitis treatment.…”