Treatment strategies for locally advanced hepatocellular carcinoma

Abstract

Liver cancer ranks fifth in incidence and fourth in overall cancer-related mortality, with approximately 854,000 new cases and 810,000 deaths per year worldwide. Hepatocellular carcinoma (HCC) accounts for 90% of these cases, and, over time, both the incidence and mortality of this cancer have been rising in many regions. Several staging systems are used to assess the extent of primary tumor, presence of metastasis, and underlying liver disease, and thereby aid in the definition of treatment strategies and prognosis for these patients. The consequence of this heterogeneity in HCC staging is that no consensual definition of advanced disease exists, and there is still ongoing debate on the optimal treatment for these patients. Patients with advanced tumors can be candidates for multiple therapies, ranging from potentially curative options such as transplantation and resection-to locoregional and systemic treatments; these should be evaluated on an individual basis by a multidisciplinary team. This paper provides an overview of treatment options for advanced stage HCC, based on a review of the latest relevant literature and the personal experience of the authors.

Targeting Receptor Tyrosine Kinase VEGFR-2 in Hepatocellular Cancer: Rational Design, Synthesis and Biological Evaluation of 1,2-Disubstituted Benzimidazoles

“…In the case of series 14a-d, the introduction of a phenyl or 2-methylphenyl group in 14a and 14b resulted in a more promising activity than the 4-bromophenyl derivatives 14c and 14d (IC50 = 25.88 and 26.16 μM, respectively vs. 112. 35 and 62.00 μM, respectively).…”

“…Recently, it was reported that overexpression of VEGFR-2 in HCC promotes pathological angiogenesis [32,33]. Hence, the application of VEGFR-2 inhibitors in HCC is considered one of the most successful approaches to hinder the growth and spread of hepatic cancer cells [33][34][35].…”

Targeting Ca2+ Signaling in the Initiation, Promotion and Progression of Hepatocellular Carcinoma

“…Stages in the development of HCC from initiation to metastasis to other regions of the liver and eventually to other tissues are summarized schematically in Figure 4 [ 3 , 10 , 59 ]. The development of HCC tumors is usually preceded by liver fibrosis and cirrhosis, although some HCCs develop without cirrhosis [ 1 , 3 , 10 , 60 ].…”

Long-term Survival of a Patient with a Large Hepatocellular Carcinoma with Main Portal Vein Tumor Thrombosis and Spontaneous Tumor Rupture

“…2,3 Meanwhile, diverse treatment approaches involving a combination of various local therapies and systemic treatments have been administered in a sequential or concurrent manner. [4][5][6] We would like to report an extraordinary case of a patient who presented with a large HCC with main portal vein tumor thrombosis (PVTT) and showed long-term survival in spite of continuous recurrence. Moreover, the tumor was already ruptured at the time of presentation and the patient was hemodynamically unstable due to intraperitoneal massive bleeding.…”