Authors: | Jarnagin, W.; Chapman, W. C.; Curley, S.; D'Angelica, M.; Rosen, C.; Dixon, E.; Nagorney, D. |
Article Title: | Surgical treatment of hepatocellular carcinoma: Expert consensus statement |
Abstract: | As the number of effective treatment options has increased, the management of patients with hepatocellular carcinoma has become complex. The most appropriate therapy depends largely on the functional status of the underlying liver. In patients with advanced cirrhosis and tumor extent within the Milan criteria, liver transplantation is clearly the best option, as this therapy treats the cancer along with the underlying hepatic parenchymal disease. As the results of transplantation has become established in patients with limited disease, investigation has increasingly focused on downstaging patients with disease outside of Milan criteria and defining the upper limits of transplantable tumors. In patients with well preserved hepatic function, liver resection is the most appropriate and effective treatment. Hepatic resection is not as constrained by tumor extent and location to the same degree as transplantation and ablative therapies. Some patients who recur after resection may still be eligible for transplantation. Ablative therapies, particularly percutaneous radiofrequency ablation and transarterial chemoembolization have been used primarily to treat patients with low volume irresectable tumors. Whether ablation of small tumors provides long term disease control that is comparable to resection remains unclear. © 2010 International Hepato-Pancreato-Biliary Association. |
Keywords: | cancer survival; treatment outcome; cancer surgery; overall survival; clinical trial; cancer localization; cancer recurrence; chemoembolization; liver cell carcinoma; liver cirrhosis; liver function; liver transplantation; patient selection; carcinoma, hepatocellular; liver neoplasms; conference paper; chemotherapy; cancer staging; neoplasm staging; laparoscopy; laparoscopic surgery; radiotherapy; morbidity; cancer mortality; high intensity focused ultrasound; surgery; liver resection; liver disease; hepatectomy; electroporation; cancer control; liver parenchyma; radiofrequency ablation; ablation therapy; partial hepatectomy; catheter ablation; laparoscopic; ablation; hepatocellular cancer; chemoembolization, therapeutic; microwave therapy; consensus conference; hepatoma; thymosin alpha1 |
Journal Title: | HPB |
Volume: | 12 |
Issue: | 5 |
ISSN: | 1365-182X |
Publisher: | Elsevier Science, Inc. |
Date Published: | 2010-06-01 |
Start Page: | 302 |
End Page: | 310 |
Language: | English |
DOI: | 10.1111/j.1477-2574.2010.00182.x |
PUBMED: | 20590903 |
PROVIDER: | scopus |
PMCID: | PMC2951816 |
DOI/URL: | |
Notes: | --- - "Cited By (since 1996): 2" - "Export Date: 20 April 2011" - "CODEN: HPBIF" - "Source: Scopus" |