Heterogeneity of Patients with Intermediate (BCLC B) Hepatocellular Carcinoma: Proposal for a Subclassification to Facilitate Treatment Decisions

被引：560

作者：

Bolondi, Luigi ^{[1
]}

Burroughs, Andrew ^{[2
,3
]}

Dufour, Jean-Francois ^{[4
,5
]}

Galle, Peter R. ^{[6
]}

Mazzaferro, Vincenzo ^{[7
]}

Piscaglia, Fabio ^{[1
]}

Raoul, Jean Luc ^{[8
]}

Sangro, Bruno ^{[9
,10
]}

机构：

[1] Univ Bologna, S Orsola Malpighi Hosp, Dept Digest Dis & Internal Med, Div Internal Med, Bologna, Italy

[2] Royal Free Hosp, Royal Free Sheila Sherlock Liver Ctr, London NW3 2QG, England

[3] UCL London, UCL Inst Liver & Digest Hlth, London, England

[4] Univ Bern, Inselspital, Univ Clin Visceral Surg & Med, CH-3010 Bern, Switzerland

[5] Univ Bern, Dept Clin Res, Bern, Switzerland

[6] Johannes Gutenberg Univ Mainz, Dept Med 1, Univ Med Ctr, D-6500 Mainz, Germany

[7] IRCCS Fdn, Natl Canc Inst, Ist Nazl Tumori, Milan, Italy

[8] Inst Paoli Calmettes, Dept Med Oncol, Marseille, France

[9] Univ Navarra Clin, Liver Unit, Pamplona, Spain

[10] Ctr Invest Biomed Red Enfermedades Hepat & Digest, Pamplona, Spain

来源：

SEMINARS IN LIVER DISEASE | 2012年 / 32卷 / 04期

关键词：

hepatocellular carcinoma; sorafenib; transarterial chemoembolization; radioembolization; Barcelona Clinic Liver Cancer; TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; CLINICAL-PRACTICE GUIDELINES; 7 STAGING SYSTEMS; TRANSARTERIAL CHEMOEMBOLIZATION; LIVER-TRANSPLANTATION; RADIOFREQUENCY ABLATION; CIRRHOTIC-PATIENTS; SURVIVAL; CANCER; RADIOEMBOLIZATION;

D O I：

10.1055/s-0032-1329906

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The intermediate stage of hepatocellular carcinoma (HCC) comprises a highly heterogeneous patient population and therefore poses unique challenges for therapeutic management, different from the early and advanced stages. Patients classified as having intermediate HCC by the Barcelona Clinic Liver Cancer (BCLC) staging system present with varying tumor burden and liver function. Transarterial chemoembolization (TACE) is currently recommended as the standard of care in this setting, but there is considerable variation in the clinical benefit patients derive from this treatment. In April 2012, a panel of experts convened to discuss unresolved issues surrounding the application of current guidelines when managing patients with intermediate HCC. The meeting explored the applicability of a subclassification system for intermediate HCC patients to tailor therapeutic interventions based on the evidence available to date and expert opinion. The present report summarizes the proposal of the expert panel: four substages of intermediate HCC patients, B1 to B4.

引用

页码：348 / 359

页数：12

共 83 条

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