Role of interventional radiology in the management of hepatocellular carcinoma: current status

Holzwanger, Daniel J.; Madoff, David C.

doi:10.21037/cco.2018.07.04

Cited by 22 publications

(21 citation statements)

References 91 publications

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“…1 depicts the Barcelona Clinic Liver Cancer system, which is one of the most commonly used algorithms to assist in determining treatment options based on the aforementioned factors. [11][12][13][14] To summarize, patients diagnosed as stage 0, with very early HCC, are ideal candidates for ablation or resection. 11 Patients who are deemed to be stage A, with early HCC, are candidates for radical therapies, including hepatoma resection, liver transplantation, or interventional radiology procedures.…”

Section: Introductionmentioning

confidence: 99%

Management and Treatment of Hepatocellular Carcinoma with Immunotherapy: A Review of Current and Future Options

Ghavimi¹,

Apfel²,

Azimi³

et al. 2020

Journal of Clinical and Translational Hepatology

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With mortality rates of liver cancer doubling in the last 20 years, this disease is on the rise and has become the fifth most common cancer in men and the seventh most common cancer in women. Hepatocellular carcinoma (HCC) represents approximately 90% of all primary liver cancers and is a major global health concern. Patients with HCC can be managed curatively with surgical resection or with liver transplantation, if they are diagnosed at an early stage. Unfortunately, most patients with HCC present with advanced stages of the disease and have underlying liver dysfunction, which allows only 15% of patients to be eligible for curative treatment. Several different treatment modalities are available, including locoregional therapy radiofrequency ablation, microwave ablation, percutaneous ethanol injection, trans-arterial chemoembolization, transarterial radio-embolization, cryoablation, radiation therapy, stereotactic radiotherapy, systemic chemotherapy, molecularly targeted therapies, and immunotherapy. Immunotherapy has recently become a promising method for inhibiting HCC tumor progression, recurrence, and metastasis. The term "Immunotherapy" is a catch-all, encompassing a wide range of applications and targets, including HCC vaccines, adoptive cell therapy, immune checkpoint inhibitors, and use of oncolytic viruses to treat HCC. Immunotherapy in HCC is a relatively safe option for treating patients with advanced disease in the USA who are either unable to receive or failed sorafenib/lenvatinib therapy and thus may offer an additional survival benefit for these patients. The purpose of this review is to elaborate on some of the most recent advancements in immunotherapy.

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Section: Introductionmentioning

confidence: 99%

Management and Treatment of Hepatocellular Carcinoma with Immunotherapy: A Review of Current and Future Options

Ghavimi¹,

Apfel²,

Azimi³

et al. 2020

Journal of Clinical and Translational Hepatology

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“…In addition, it results in a faster and more homogeneous tissue heating. 4,5 Up to now, MWA and RFA achieved comparable results in clinical studies regarding outcomes and complication rates after HCC treatment. 6,7 cell damage.…”

Section: Microwave Ablationmentioning

confidence: 95%

Ablation in Primary Liver Tumors

2019

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Minimal invasive thermal ablation techniques have a key role in the treatment regimen of primary liver tumors. These relatively low-risk procedures are established in nonresectable liver tumors and even challenge the surgical approach, which is regarded as first-line treatment in eligible patients.The location and size of the liver tumor, the applied ablation, and guidance technique are crucial for treatment outcome. The confirmation of an adequate ablation zone including sufficient tumor overlap and a safety margin (A0 ablation analogous to R0 resection) is crucial to minimize local recurrence rates and improve survival. A variety of different ablation devices is available. The outcome of conventional computed tomography- or ultrasound-guided thermal ablation in small lesions is well comparable to surgery. However, in liver lesions with large diameter overlapping ablation zones are required to ensure an adequate ablation margin. Therefore, stereotactic techniques in combination with a multiple needle approach, three-dimensional trajectory planning, and image fusion for intraoperative treatment evaluation have been successfully introduced.

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“…Unipolar or multipolar probes are available. RFA has been investigated in large patient cohorts and has resulted as reliable and feasible technique [11].…”

Section: Radiofrequency Ablationmentioning

confidence: 99%

Locoregional ablative treatment of melanoma metastases

Putzer

Schullian

Bale

2019

International Journal of Hyperthermia

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Standard treatment of melanoma has been evolving rapidly over the last decade, with novel treatment approaches improving therapeutic outcome not only in early-stage disease but also in advanced stage metastatic patients. Despite the improvement of systemic therapy outcomes, the current treatment guidelines reflect the fact that locoregional treatment approaches can be beneficial in patients suffering from oligometastatic disease. Minimally invasive ablation techniques have been established as a therapeutic cornerstone in the management of liver tumors, representing a local curative, relatively low-risk procedure. Depending on the size and location of metastatic disease, and on the applied ablation and guidance technique, ablative treatment approaches are effective to treat metastases in solid organs such as the liver or lungs, effectively covering the entire tumor with the ablation zone including a safety margin (A0 ablation in analogy to R0 resection). However, only retrospective data and case reports on locoregional treatment of melanoma metastases are available up to now, and prospective evaluation of this therapeutic approach is warranted to evaluate the beneficial role in the treatment of metastatic melanoma patients.

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Role of interventional radiology in the management of hepatocellular carcinoma: current status

Cited by 22 publications

References 91 publications

Management and Treatment of Hepatocellular Carcinoma with Immunotherapy: A Review of Current and Future Options

Management and Treatment of Hepatocellular Carcinoma with Immunotherapy: A Review of Current and Future Options

Ablation in Primary Liver Tumors

Locoregional ablative treatment of melanoma metastases

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