Nonoperative therapies for combined modality treatment of hepatocellular cancer: Expert consensus statement Journal Article
| Authors: | Schwarz, R. E.; Abou-Alfa, G. K.; Geschwind, J. F.; Krishnan, S.; Salem, R.; Venook, A. P. |
| Article Title: | Nonoperative therapies for combined modality treatment of hepatocellular cancer: Expert consensus statement |
| Abstract: | Although surgical resection and liver transplantation are the only treatment modalities that enable prolonged survival in patients with hepatocellular carcinoma (HCC), the majority of HCC patients presents with advanced disease and do not undergo resective or ablative therapy. Transarterial chemoembolization (TACE) is indicated in intermediate/advanced stage unresectable HCC even in the setting of portal vein involvement (excluding main portal vein). Sorafenib has been shown to improve survival of patients with advanced HCC in two controlled randomized trials. Yttrium 90 is a safe microembolization treatment that can be used as an alternative to TACE in patients with advanced liver only disease or in case of portal vein thrombosis. External beam radiation can be helpful to provide local control in selected unresectable HCC. These different treatment modalities may be combined in the treatment strategy of HCC and also used as a bridge to resection or liver transplantation. Patients should undergo formal multidisciplinary evaluation prior to initiating any such treatment in order to individualize the best available options. © 2010 International Hepato-Pancreato-Biliary Assoc. |
| Keywords: | cancer survival; treatment outcome; cancer surgery; clinical trial; sorafenib; bevacizumab; cisplatin; doxorubicin; erlotinib; iodinated poppyseed oil; sunitinib; advanced cancer; ascites; chemoembolization; gastrointestinal hemorrhage; liver cell carcinoma; liver transplantation; multimodality cancer therapy; patient selection; side effect; systemic therapy; antineoplastic agents; benzenesulfonates; carcinoma, hepatocellular; liver neoplasms; pyridines; conference paper; cancer patient; cancer radiotherapy; chemotherapy; cancer staging; neoplasm staging; radiopharmaceuticals; treatment indication; computer assisted tomography; vomiting; radiotherapy; abdominal pain; fever; protein kinase inhibitors; mitoxantrone; surgery; epirubicin; mitomycin c; hepatectomy; external beam radiotherapy; photon therapy; cancer control; portal vein thrombosis; floxuridine; bilirubin blood level; yttrium; portal vein; ablation therapy; hepatocellular cancer; chemoembolization, therapeutic; 1 [4 (3 amino 1h indazol 4 yl)phenyl] 3 (2 fluoro 5 methylphenyl)urea; brivanib; consensus conference; hepatoma; microsphere; yttrium 90 |
| Journal Title: | HPB |
| Volume: | 12 |
| Issue: | 5 |
| ISSN: | 1365-182X |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2010-06-01 |
| Start Page: | 313 |
| End Page: | 320 |
| Language: | English |
| DOI: | 10.1111/j.1477-2574.2010.00183.x |
| PUBMED: | 20590905 |
| PROVIDER: | scopus |
| PMCID: | PMC2951818 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 2" - "Export Date: 20 April 2011" - "CODEN: HPBIF" - "Source: Scopus" |
