BACKGROUND: Hepatocellular carcinoma (HCC) significantly contributes to the global burden of cancer. Liver cancer is the third most frequent cause of cancer-related death, with HCC representing more than 90% of primary liver cancers. During the last decade, much progress has been made with respect to the definition of patient populations at risk who may benefit from surveillance strategies, as well as in the diagnosis and treatment of the disease. SUMMARY: New locoregional and systemic therapies have significantly increased the survival of patients with HCC. A multitude of clinical trials addressing patients with HCC have led to advancements in the allocation of subgroups of patients to their optimal individual treatment strategy. This review provides an overview on recent developments in diagnostic and therapeutic modalities and an outlook on future directions in the management of HCC. KEY MESSAGE: New locoregional and systemic therapies in patients with HCC have significantly improved clinical outlook and patient survival. This review provides an overview of recent developments in diagnostics and therapeutics, as well as an outlook on future directions in the management of HCC. PRACTICAL IMPLICATIONS: Transabdominal ultrasound is the method of choice for the surveillance of patients at risk of developing HCC, and any suspicious focal lesion in the liver should be characterized. Contrast-enhanced ultrasound with application of second-generation contrast agents enables visualization of tumor vascularity. The Barcelona Clinic Liver Cancer (BCLC) system is the most widely used classification system to guide the clinical management of HCC. Liver resection should be considered for patients with well-preserved liver function and without portal hypertension or elevated bilirubin. Patients not suitable for resection should undergo local tumor ablation. Candidates who are eligible for liver transplantation may benefit from bridging therapy during their waiting period. Patients in the BCLC B category benefit from locoregional transarterial therapy; transarterial chemoembolization is the treatment of choice. Sorafenib is the only systemic therapy that has been shown to prolong overall survival in patients with advanced disease, and is therefore recommended in patients with well-preserved liver function.
BACKGROUND:Hepatocellular carcinoma (HCC) significantly contributes to the global burden of cancer. Liver cancer is the third most frequent cause of cancer-related death, with HCC representing more than 90% of primary liver cancers. During the last decade, much progress has been made with respect to the definition of patient populations at risk who may benefit from surveillance strategies, as well as in the diagnosis and treatment of the disease. SUMMARY: New locoregional and systemic therapies have significantly increased the survival of patients with HCC. A multitude of clinical trials addressing patients with HCC have led to advancements in the allocation of subgroups of patients to their optimal individual treatment strategy. This review provides an overview on recent developments in diagnostic and therapeutic modalities and an outlook on future directions in the management of HCC. KEY MESSAGE: New locoregional and systemic therapies in patients with HCC have significantly improved clinical outlook and patient survival. This review provides an overview of recent developments in diagnostics and therapeutics, as well as an outlook on future directions in the management of HCC. PRACTICAL IMPLICATIONS: Transabdominal ultrasound is the method of choice for the surveillance of patients at risk of developing HCC, and any suspicious focal lesion in the liver should be characterized. Contrast-enhanced ultrasound with application of second-generation contrast agents enables visualization of tumor vascularity. The Barcelona Clinic Liver Cancer (BCLC) system is the most widely used classification system to guide the clinical management of HCC. Liver resection should be considered for patients with well-preserved liver function and without portal hypertension or elevated bilirubin. Patients not suitable for resection should undergo local tumor ablation. Candidates who are eligible for liver transplantation may benefit from bridging therapy during their waiting period. Patients in the BCLC B category benefit from locoregional transarterial therapy; transarterial chemoembolization is the treatment of choice. Sorafenib is the only systemic therapy that has been shown to prolong overall survival in patients with advanced disease, and is therefore recommended in patients with well-preserved liver function.
Authors: Riad Salem; Robert J Lewandowski; Laura Kulik; Edward Wang; Ahsun Riaz; Robert K Ryu; Kent T Sato; Ramona Gupta; Paul Nikolaidis; Frank H Miller; Vahid Yaghmai; Saad M Ibrahim; Seanthan Senthilnathan; Talia Baker; Vanessa L Gates; Bassel Atassi; Steven Newman; Khairuddin Memon; Richard Chen; Robert L Vogelzang; Albert A Nemcek; Scott A Resnick; Howard B Chrisman; James Carr; Reed A Omary; Michael Abecassis; Al B Benson; Mary F Mulcahy Journal: Gastroenterology Date: 2010-10-30 Impact factor: 22.682
Authors: Bruno Sangro; Livio Carpanese; Roberto Cianni; Rita Golfieri; Daniele Gasparini; Samer Ezziddin; Philipp M Paprottka; Francesco Fiore; Mark Van Buskirk; Jose Ignacio Bilbao; Giuseppe Maria Ettorre; Rita Salvatori; Emanuela Giampalma; Onelio Geatti; Kai Wilhelm; Ralf Thorsten Hoffmann; Francesco Izzo; Mercedes Iñarrairaegui; Carlo Ludovico Maini; Carlo Urigo; Alberta Cappelli; Alessandro Vit; Hojjat Ahmadzadehfar; Tobias Franz Jakobs; Secondo Lastoria Journal: Hepatology Date: 2011-06-30 Impact factor: 17.425
Authors: Johannes Lammer; Katarina Malagari; Thomas Vogl; Frank Pilleul; Alban Denys; Anthony Watkinson; Michael Pitton; Geraldine Sergent; Thomas Pfammatter; Sylvain Terraz; Yves Benhamou; Yves Avajon; Thomas Gruenberger; Maria Pomoni; Herbert Langenberger; Marcus Schuchmann; Jerome Dumortier; Christian Mueller; Patrick Chevallier; Riccardo Lencioni Journal: Cardiovasc Intervent Radiol Date: 2009-11-12 Impact factor: 2.740
Authors: Ahmed Alksas; Mohamed Shehata; Gehad A Saleh; Ahmed Shaffie; Ahmed Soliman; Mohammed Ghazal; Adel Khelifi; Hadil Abu Khalifeh; Ahmed Abdel Razek; Guruprasad A Giridharan; Ayman El-Baz Journal: Sci Rep Date: 2021-06-23 Impact factor: 4.379