Multimodal treatment of hepatocellular carcinoma (HCC)

Onkologie
J W Sturm, M A Keese

Abstract

Screening of patients at risk for hepatocellular carcinomas (HCC) and preventive virustatic therapy are the first steps in a multimodal treatment concept, because delayed detection leads to a poor prognosis with median survival of <10 months. Surgical resection of HCC is still the treatment of choice in patients with good residual liver function, however, recurrence-free 5-year survival after curative resection is low (33%). In patients with cirrhosis, only 25% of HCC are resectable, limited by low hepatic functional reserve. HCC in patients with non-cirrhotic livers are the domain of extended resections. In newer reports, transplantation in patients with cirrhosis is rated more positively when restricted to patients with solitary nodules <5 cm or up to 3 tumors <3 cm. A new option in HCC therapy are the local methods for tumor ablation, preferably radiofrequency ablation (RFA), especially in patients with limited liver function, non-resectable or multifocal tumors. A new horizon is opened combining these options and multimodal approaches with transarterial chemoembolisation (TACE). This trend to multimodal approaches promises a yet unknown improvement in the prognosis of patients with HCC. Controlled randomized studies compari...Continue Reading

Citations

Dec 6, 2005·Cardiovascular and Interventional Radiology·G GaffkeC Stroszczynski

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