Novel implications in the treatment of hepatocellular carcinoma

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Novel implications in the treatment of hepatocellular carcinoma (EN)

Schotten, Clemens; Department of Gastroenterology and Hepatology, University Hospital Essen, Essen
Dechêne, Alexander; Department of Gastroenterology and Hepatology, University Hospital Essen, Essen
Wetter, Axel; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen
Theysohn, Jens M.; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen
Schulze, Maren; Department of Transplant and General Surgery, University Hospital Essen, Essen
Best, Jan; Department of Gastroenterology and Hepatology, University Hospital Essen, Essen
Müller, Stefan; Department of Nuclear Medicine, University Hospital Essen, Essen
Gerken, Guido; Department of Gastroenterology and Hepatology, University Hospital Essen, Essen
Canbay, Ali; Department of Gastroenterology and Hepatology, University Hospital Essen, Essen
Radünz, Sonia; Department of Transplant and General Surgery, University Hospital Essen, Essen

Worldwide hepatocellular carcinoma remains one of the leading causes of cancer-related death, associated with a poor prognosis due to late diagnosis in the majority of cases. Physicians at care are frequently confronted with patients who are ineligible for curative treatment such as liver resection, transplantation or radiofrequency ablation. Besides established palliative locoregional therapies, such as ablation or chemoembolization, new treatment options, such as microwave ablation, drug-eluting bead transarterial chemoembolization or selective internal radiation therapy, are emerging; however, data from randomized controlled trials are still lacking. In order to achieve optimal tumor control, patients should receive tailored treatment concepts, considering their tumor burden, liver function and performance status, instead of strictly assigning patients to treatment modalities following algorithms that may be partly very restrictive. Palliative locoregional pretreatment might facilitate downstaging to ensure later curative resection or transplantation. In addition, the combined utilization of different locoregional treatment options or systemic co-treatment has been the subject of several trials. In cases where local tumor control cannot be achieved, or in the scenario of extrahepatic spread, sorafenib remains the only approved systemic therapy option. Alternative targeted therapies, such as immune checkpoint inhibitors have shown encouraging preliminary results, while data from phase III studies are pending.Keywords Hepatocellular carcinoma, liver surgery, locoregional therapy, systemic therapy, individualized treatment conceptAnn Gastroenterol 2017; 30 (1): 23-32 (EN)

Ελληνική Γαστροεντερολογική Εταιρία (EL)
Hellenic Gastroenterologiki Company (EN)

2016-12-29


Annals of Gastroenterology (EN)

Annals of Gastroenterology; Volume 30, No 1 (2017); 23 (EN)



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