A Review and Update of Treatment Options and Controversies in the Management of Hepatocellular Carcinoma

被引:297
作者
Dhir, Mashaal [1 ]
Melin, Alyson A. [2 ]
Douaiher, Jeffrey [2 ]
Lin, Chi [3 ]
Zhen, Weining [3 ]
Hussain, Shahid M. [4 ]
Geschwind, Jean-Francois H. [5 ]
Doyle, Maria B. Majella [6 ]
Abou-Alfa, Ghassan K. [7 ]
Are, Chandrakanth [2 ]
机构
[1] Univ Pittsburgh, Med Ctr, Dept Surg, Div Surg Oncol, Pittsburgh, PA USA
[2] Univ Nebraska Med Ctr, Dept Surg, Div Surg Oncol, Omaha, NE 68198 USA
[3] Univ Nebraska Med Ctr, Dept Radiat Oncol, Omaha, NE 68198 USA
[4] Univ Nebraska Med Ctr, Dept Radiol, Omaha, NE 68198 USA
[5] Johns Hopkins Sch Med, Dept Radiol Surg & Oncol, Baltimore, MD USA
[6] Washington Univ, Sch Med, Dept Surg, Div Gen Surg,Abdominal Transplantat Sect, St Louis, MO 63110 USA
[7] Weill Cornell Med Coll, Mem Sloan Kettering Canc Ctr, Dept Med Oncol, New York, NY USA
关键词
ablation; hepatocellular carcinoma; locoregional therapies; management; radiation; resection; systemic therapies; transplant; PORTAL-VEIN EMBOLIZATION; DRUG-ELUTING BEADS; LIVER-TRANSPLANTATION; TRANSARTERIAL CHEMOEMBOLIZATION; RADIOFREQUENCY ABLATION; SURGICAL-TREATMENT; RADIATION-THERAPY; ETHANOL INJECTION; RESECTION; OUTCOMES;
D O I
10.1097/SLA.0000000000001556
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: To review the current management, outline recent advances and address controversies in the management of hepatocellular carcinoma (HCC). Summary of Background data: The treatment of HCC is multidisciplinary involving hepatologists, surgeons, medical oncologists, radiation oncologists, radiologists, interventional radiologists, and other disciplines. Each of these disciplines brings its unique perspective and differing opinions that add to controversies in the management of HCC. Methods: A focused literature review was performed to identify recent studies on the management of HCC and thereby summarize relevant information on the various therapeutic modalities and controversies involved in the treatment of HCC. Results: The main treatment algorithms continue to rely on hepatic resection or transplantation with controversies involving patients harboring early stage disease and borderline hepatic function. The other treatment strategies include locoregional therapies, radiation, and systemic therapy used alone or in combination with other treatment modalities. Recent advances in locoregional therapies, radiation, and systemic therapies have provided better therapeutic options with curative intent potential for some locoregional therapies. Further refinements in combination therapies such as algorithms consisting of locoregional therapies and systemic or radiation therapies are likely to add additional options and improve survival. Conclusions: The management of HCC has witnessed significant strides with advances in existing options and introduction of several new treatment modalities of various combinations. Further refinements in these treatment options combined with enrollment in clinical trials are essential to improve the management and outcomes of patients with HCC.
引用
收藏
页码:1112 / 1125
页数:14
相关论文
共 75 条
[1]   The antiangiogenic ceiling in hepatocellular carcinoma: does it exist and has it been reached? [J].
Abou-Alfa, Ghassan K. ;
Venook, Alan P. .
LANCET ONCOLOGY, 2013, 14 (07) :E283-E288
[2]   TACE and Sorafenib: A Good Marriage? [J].
Abou-Alfa, Ghassan K. .
JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (30) :3949-3952
[3]   Preoperative portal vein embolization for major liver resection - A meta-analysis [J].
Abulkhir, Adel ;
Limongelli, Paolo ;
Healey, Andrew J. ;
Damrah, Osama ;
Tait, Paul ;
Jackson, James ;
Habib, Nagy ;
Jiao, Long R. .
ANNALS OF SURGERY, 2008, 247 (01) :49-57
[4]  
American Association for the Study of Liver Diseases/Infectious Diseases Society of America/International Antiviral Society (AASLD/IDSA/IAS)-USA, REC TEST MAN TREAT H
[5]  
[Anonymous], LIVER TRANSPL
[6]  
[Anonymous], LIV IM REP DAT SYST
[7]   Treatment before liver transplantation for HCC [J].
Belghiti, J. ;
Carr, B. I. ;
Greig, P. D. ;
Lencioni, R. ;
Poon, R. T. .
ANNALS OF SURGICAL ONCOLOGY, 2008, 15 (04) :993-1000
[8]   Hepatobiliary Cancers, Version 2.2014 [J].
Benson, Al B. ;
D'Angelica, Michael I. ;
Abrams, Thomas A. ;
Are, Chandrakanth ;
Bloomston, P. Mark ;
Chang, Daniel T. ;
Clary, Bryan M. ;
Covey, Anne M. ;
Ensminger, William D. ;
Iyer, Renuka ;
Kelley, R. Kate ;
Linehan, David ;
Malafa, Mokenge P. ;
Meranze, Steven G. ;
Park, James O. ;
Pawlik, Timothy ;
Posey, James A. ;
Scaife, Courtney ;
Schefter, Tracey ;
Sigurdson, Elin R. ;
Tian, G. Gary ;
Vauthey, Jean-Nicolas ;
Venook, Alan P. ;
Yen, Yun ;
Zhu, Andrew X. ;
Hoffmann, Karin G. ;
McMillian, Nicole R. ;
Sundar, Hema .
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK, 2014, 12 (08) :1152-1182
[9]   Mortality and complication rates of percutaneous ablative techniques for the treatment of liver tumors: a systematic review [J].
Bertot, Luis Calzadilla ;
Sato, Masaya ;
Tateishi, Ryosuke ;
Yoshida, Haruhiko ;
Koike, Kazuhiko .
EUROPEAN RADIOLOGY, 2011, 21 (12) :2584-2596
[10]   Management of hepatoceullular carcinoma [J].
Bruix, J ;
Sherman, M .
HEPATOLOGY, 2005, 42 (05) :1208-1236