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[Multimodal therapy concepts in hepatocellular carcinoma]
1Centre Hépato-Biliare, Assistance Publique-Hopitaux de Paris, Université Paris Sud, Hopital Paul Brousse, Villejuif, France.
Zentralblatt Fur Chirurgie
|August 29, 2000
Summary
Liver transplantation offers improved survival for select patients with small hepatocellular carcinoma (HCC) compared to resection. Alternative treatments like liver resection or percutaneous ethanol injection (PEI) are options for other patients.
Area of Science:
- Hepatology
- Oncology
- Transplantation Surgery
Context:
- Hepatocellular carcinoma (HCC) is a severe complication of liver cirrhosis with limited cure rates.
- Liver transplantation outcomes for HCC have improved, allowing for patient subgroup definition.
- Current treatment options for HCC have limitations, necessitating exploration of alternatives.
Purpose:
- To define a subgroup of HCC patients who benefit most from liver transplantation.
- To outline alternative palliative treatments for HCC patients unsuitable for transplantation.
- To discuss emerging therapies and future directions in HCC management.
Summary:
- Liver transplantation provides superior disease-free survival for select HCC patients (small tumors, <3 nodules, no portal vein thrombus) compared to resection.
- For patients with contraindications or long transplant waiting times, liver resection offers palliative treatment.
- Percutaneous ethanol injection (PEI) and other ablative therapies (radio-frequency, thermal, cryo-therapy) are effective for small HCC, often requiring fewer sessions than PEI.
Impact:
- Identifies a specific patient cohort for improved HCC treatment outcomes via liver transplantation.
- Provides evidence-based alternative treatment strategies for HCC patients ineligible for transplantation.
- Highlights the importance of screening, prevention, and innovative therapies like gene therapy for future HCC management.