Conversion therapy for initially unresectable hepatocellular carcinoma: Current status and prospects

Area of Science:

• Hepatocellular Carcinoma Research
• Oncology
• Surgical Oncology

Background:

• Locoregional and/or systemic treatments can downstage unresectable hepatocellular carcinoma (HCC) for surgical resection.
• Conversion therapy followed by curative surgery offers significant survival benefits over other treatment modalities.

Purpose of the Study:

• To evaluate the efficacy and complications of conversion therapy for unresectable HCC.
• To highlight the benefits of combined locoregional plus systemic conversion therapy.
• To emphasize the need for established criteria and further clinical evidence.

Main Methods:

• Review of existing research on conversion therapy for HCC.
• Analysis of conversion rates, objective remission rates, and disease control rates.
• Assessment of complications associated with conversion therapy.

Main Results:

• Conversion therapy success rates vary widely (0.8%–60%).
• Combined locoregional plus systemic therapy shows high efficacy (up to 60% conversion rate, 96% objective remission, 100% disease control).
• Conversion therapy significantly increases complications like hepatotoxicity and surgical difficulty.

Conclusions:

• Conversion therapy, especially combined approaches, can enable curative surgery and improve survival in HCC patients.
• Increased surgical complications necessitate careful patient selection and management.
• Further clinical evidence and standardized evaluation criteria are crucial for optimizing conversion therapy.