Treatment Strategies for Hepatocellular CarcinomaA Multidisciplinary Approach

Isabella Lurje, Zoltan Czigany, Jan Bednarsch, Christoph Roderburg, Peter Isfort, Ulf Peter Neumann, Georg Lurje*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and its mortality is third among all solid tumors, behind carcinomas of the lung and the colon. Despite continuous advancements in the management of this disease, the prognosis for HCC remains inferior compared to other tumor entities. While orthotopic liver transplantation (OLT) and surgical resection are the only two curative treatment options, OLT remains the best treatment strategy as it not only removes the tumor but cures the underlying liver disease. As the applicability of OLT is nowadays limited by organ shortage, major liver resectionseven in patients with underlying chronic liver diseaseare adopted increasingly into clinical practice. Against the background of the oftentimes present chronical liver disease, locoregional therapies have also gained increasing significance. These strategies range from radiofrequency ablation and trans-arterial chemoembolization to selective internal radiation therapy and are employed in both curative and palliative intent, individually, as a bridging to transplant or in combination with liver resection. The choice of the appropriate treatment, or combination of treatments, should consider the tumor stage, the function of the remaining liver parenchyma, the future liver remnant volume and the patient's general condition. This review aims to address the topic of multimodal treatment strategies in HCC, highlighting a multidisciplinary treatment approach to further improve outcome in these patients.

Original languageEnglish
Article number1465
Number of pages27
JournalInternational journal of molecular sciences
Volume20
Issue number6
DOIs
Publication statusPublished - 21 Mar 2019

Keywords

  • Hepatocellular carcinoma
  • liver cirrhosis
  • liver transplantation
  • liver resection
  • multimodal treatment
  • LONG-TERM SURVIVAL
  • PERCUTANEOUS RADIOFREQUENCY ABLATION
  • INTERNAL RADIATION-THERAPY
  • TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION
  • STEREOTACTIC BODY RADIOTHERAPY
  • FOCUSED ULTRASOUND ABLATION
  • PORTAL-VEIN EMBOLIZATION
  • PRIMARY LIVER-CANCER
  • TRANSARTERIAL CHEMOEMBOLIZATION
  • MICROWAVE ABLATION

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