LOCO-REGIONAL APPROACH IN THE TREATMENT OF HEPATOCELLULAR CARCINOMA
Abstract
Hepatocellular carcinoma ranks 5th in terms of the most frequent neoplasms, currently constituting one of the main causes of death from cancer. The vast investigation and growing knowledge on the mechanisms of this neoplasia, allowed the development of a set of therapies, which can be used alone or combined, thus contributing to a change in the treatment paradigm for these patients. Liver resection is the method of choice for approaching this carcinoma, however transplantation remains a curative option used when hepatectomy is contraindicated. The development of loco-regional ablation and embolization techniques has shown great efficacy and a growing interest in tumor combat, either alone or in conjunction with surgery, as they often allow tumor regression so that hepatocellular carcinoma meets the criteria for resectability and / or transplantation. Systemic targeted therapy, immunotherapy and the combination of loco-regional techniques have contributed to the possibility of curing this neoplasia. The author reviewed the various therapeutic options for approaching hepatocellular carcinoma currently used.
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References
1. Dhir M, Melin AA, Douaiher J, Lin C, Zhen WK, Hussain SM, et al. A review and update of treatment options and controversies in the management of hepatocellular carcinoma. Ann Surg. 2016;263(6):1112–25.
2. Knox JJ, Cleary SP, Dawson LA. Localized and systemic approaches to treating hepatocellular carcinoma. J Clin Oncol Off J Am Soc Clin Oncol. 2015 Jun;33(16):1835–44.
3. Couri T, Pillai A. Goals and targets for personalized therapy for HCC. Hepatol Int. 2019 Mar;13(2):125–37.
4. Brito AF, Abrantes AM, Tralhão JG, Botelho MF. Targeting hepatocellular carcinoma: What did we discover so far? Oncol Rev. 2016;10(2):47–53.
5. Cauchy F, Fuks D, Belghiti J. HCC: current surgical treatment concepts. Langenbeck’s Arch Surg. 2012 Jun;397(5):681–95.
6. Llovet JM, Ducreux M, Lencioni R, Di Bisceglie AM, Galle PR, Dufour JF, et al. EASL-EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol [Internet]. 2012;56(4):908–43. Available from: http://dx.doi.org/10.1016/j.jhep.2011.12.001
7. Gomes MA, Priolli DG, Tralhão JG, Botelho MF. Hepatocellular carcinoma: Epidemiology, biology, diagnosis, and therapies. Rev Assoc Med Bras. 2013;59(5):514–24.
8. Bruix J, Reig M, Sherman M. Evidence-Based Diagnosis, Staging, and Treatment of Patients with Hepatocellular Carcinoma. Gastroenterology [Internet]. 2016;150(4):835–53. Available from: http://dx.doi.org/10.1053/j.gastro.2015.12.041
9. Forner A, Reig M, Varela M, Burrel M, Feliu J, Briceño J, et al. Diagnosis and treatment of hepatocellular carcinoma. Update consensus document from the AEEH, SEOM, SERAM, SERVEI and SETH. Med Clin (Barc). 2016;146(11):511.e1-511.e22.
10. Grandhi MS, Kim AK, Ronnekleiv-Kelly SM, Kamel IR, Ghasebeh MA, Pawlik TM. Hepatocellular carcinoma: From diagnosis to treatment. Surg Oncol [Internet]. 2016;25(2):74–85. Available from: http://dx.doi.org/10.1016/j.suronc.2016.03.002
11. Takayama T. Surgical treatment for hepatocellular carcinoma. Jpn J Clin Oncol. 2011 Apr;41(4):447–54.
12. Akoad ME, Pomfret EA. Surgical resection and liver transplantation for hepatocellular carcinoma. Clin Liver Dis. 2015 May;19(2):381–99.
13. Padhya KT, Marrero JA, Singal AG. Recent advances in the treatment of hepatocellular carcinoma. Curr Opin Gastroenterol. 2013 May;29(3):285–92.
14. Lurje I, Czigany Z, Bednarsch J, Roderburg C, Isfort P, Neumann UP, et al. Treatment strategies for hepatocellular carcinoma—A multidisciplinary approach. Int J Mol Sci. 2019;20(6):1–24.
15. De Lope CR, Tremosini S, Forner A, Reig M, Bruix J. Management of HCC. J Hepatol. 2012;56(SUPPL. 1):75–87.
16. Proneth A, Zeman F, Schlitt HJ, Schnitzbauer AA. Is resection or transplantation the ideal treatment in patients with hepatocellular carcinoma in cirrhosis if both are possible? A systematic review and metaanalysis. Ann Surg Oncol. 2014 Sep;21(9):3096–107.
17. Chong CCN, Lee KF, Cheung SYS, Chu CCM, Fong AKW, Wong J, et al. Prospective double-blinded randomized controlled trial of Microwave versus RadioFrequency Ablation for hepatocellular carcinoma (McRFA trial). HPB (Oxford). 2020 Aug;22(8):1121–7.
18. Azab M, Zaki S, El-Shetey AG, Abdel-Moty MF, Alnoomani NMG, Gomaa AA, et al. Radiofrequency ablation combined with percutaneous ethanol injection in patients with hepatocellular carcinoma. Arab J Gastroenterol [Internet]. 2011 Sep;12(3):113–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1687197911000785
19. Huang J, Hernandez-Alejandro R, Croome KP, Yan L, Wu H, Chen Z, et al. Radiofrequency ablation versus surgical resection for hepatocellular carcinoma in Childs A cirrhotics-a retrospective study of 1,061 cases. J Gastrointest Surg. 2011 Feb;15(2):311–20.
20. Kang TW, Lim HK, Cha DI. Percutaneous ablation for perivascular hepatocellular carcinoma: Refining the current status based on emerging evidence and future perspectives. World J Gastroenterol. 2018;24(47):5331–7.
21. Sartori S, Tombesi P, Di Vece F. Radiofrequency, microwave, and laser ablation of liver tumors: time to move toward a tailored ablation technique? Hepatoma Res. 2015;1(2):52.
22. Hu KQ. Advances in clinical application of cryoablation therapy for hepatocellular carcinoma and metastatic liver tumor. J Clin Gastroenterol. 2014;48(10):830–6.
23. Delhaye C, Hendlisz A, Vouche M. Update on transarterial approaches to locoregional treatment in hepatocellular carcinoma. Curr Opin Oncol. 2019;31(4):339–45.
24. Sangro B, Iñarrairaegui M, Bilbao JI. Radioembolization for hepatocellular carcinoma. J Hepatol [Internet]. 2012;56(2):464–73. Available from: http://dx.doi.org/10.1016/j.jhep.2011.07.012
25. Chauhan N, Bukovcan J, Boucher E, Cosgrove D, Edeline J, Hamilton B, et al. Intra-Arterial TheraSphere Yttrium-90 Glass Microspheres in the Treatment of Patients With Unresectable Hepatocellular Carcinoma: Protocol for the STOP-HCC Phase 3 Randomized Controlled Trial. JMIR Res Protoc. 2018 Aug;7(8):e11234.
26. Reig M, Forner A, Rimola J, Ferrer-Fàbrega J, Burrel M, Garcia-Criado Á, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol [Internet]. 2022;76(3):681–93. Available from: https://doi.org/10.1016/j. jhep.2021.11.018
2. Knox JJ, Cleary SP, Dawson LA. Localized and systemic approaches to treating hepatocellular carcinoma. J Clin Oncol Off J Am Soc Clin Oncol. 2015 Jun;33(16):1835–44.
3. Couri T, Pillai A. Goals and targets for personalized therapy for HCC. Hepatol Int. 2019 Mar;13(2):125–37.
4. Brito AF, Abrantes AM, Tralhão JG, Botelho MF. Targeting hepatocellular carcinoma: What did we discover so far? Oncol Rev. 2016;10(2):47–53.
5. Cauchy F, Fuks D, Belghiti J. HCC: current surgical treatment concepts. Langenbeck’s Arch Surg. 2012 Jun;397(5):681–95.
6. Llovet JM, Ducreux M, Lencioni R, Di Bisceglie AM, Galle PR, Dufour JF, et al. EASL-EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol [Internet]. 2012;56(4):908–43. Available from: http://dx.doi.org/10.1016/j.jhep.2011.12.001
7. Gomes MA, Priolli DG, Tralhão JG, Botelho MF. Hepatocellular carcinoma: Epidemiology, biology, diagnosis, and therapies. Rev Assoc Med Bras. 2013;59(5):514–24.
8. Bruix J, Reig M, Sherman M. Evidence-Based Diagnosis, Staging, and Treatment of Patients with Hepatocellular Carcinoma. Gastroenterology [Internet]. 2016;150(4):835–53. Available from: http://dx.doi.org/10.1053/j.gastro.2015.12.041
9. Forner A, Reig M, Varela M, Burrel M, Feliu J, Briceño J, et al. Diagnosis and treatment of hepatocellular carcinoma. Update consensus document from the AEEH, SEOM, SERAM, SERVEI and SETH. Med Clin (Barc). 2016;146(11):511.e1-511.e22.
10. Grandhi MS, Kim AK, Ronnekleiv-Kelly SM, Kamel IR, Ghasebeh MA, Pawlik TM. Hepatocellular carcinoma: From diagnosis to treatment. Surg Oncol [Internet]. 2016;25(2):74–85. Available from: http://dx.doi.org/10.1016/j.suronc.2016.03.002
11. Takayama T. Surgical treatment for hepatocellular carcinoma. Jpn J Clin Oncol. 2011 Apr;41(4):447–54.
12. Akoad ME, Pomfret EA. Surgical resection and liver transplantation for hepatocellular carcinoma. Clin Liver Dis. 2015 May;19(2):381–99.
13. Padhya KT, Marrero JA, Singal AG. Recent advances in the treatment of hepatocellular carcinoma. Curr Opin Gastroenterol. 2013 May;29(3):285–92.
14. Lurje I, Czigany Z, Bednarsch J, Roderburg C, Isfort P, Neumann UP, et al. Treatment strategies for hepatocellular carcinoma—A multidisciplinary approach. Int J Mol Sci. 2019;20(6):1–24.
15. De Lope CR, Tremosini S, Forner A, Reig M, Bruix J. Management of HCC. J Hepatol. 2012;56(SUPPL. 1):75–87.
16. Proneth A, Zeman F, Schlitt HJ, Schnitzbauer AA. Is resection or transplantation the ideal treatment in patients with hepatocellular carcinoma in cirrhosis if both are possible? A systematic review and metaanalysis. Ann Surg Oncol. 2014 Sep;21(9):3096–107.
17. Chong CCN, Lee KF, Cheung SYS, Chu CCM, Fong AKW, Wong J, et al. Prospective double-blinded randomized controlled trial of Microwave versus RadioFrequency Ablation for hepatocellular carcinoma (McRFA trial). HPB (Oxford). 2020 Aug;22(8):1121–7.
18. Azab M, Zaki S, El-Shetey AG, Abdel-Moty MF, Alnoomani NMG, Gomaa AA, et al. Radiofrequency ablation combined with percutaneous ethanol injection in patients with hepatocellular carcinoma. Arab J Gastroenterol [Internet]. 2011 Sep;12(3):113–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1687197911000785
19. Huang J, Hernandez-Alejandro R, Croome KP, Yan L, Wu H, Chen Z, et al. Radiofrequency ablation versus surgical resection for hepatocellular carcinoma in Childs A cirrhotics-a retrospective study of 1,061 cases. J Gastrointest Surg. 2011 Feb;15(2):311–20.
20. Kang TW, Lim HK, Cha DI. Percutaneous ablation for perivascular hepatocellular carcinoma: Refining the current status based on emerging evidence and future perspectives. World J Gastroenterol. 2018;24(47):5331–7.
21. Sartori S, Tombesi P, Di Vece F. Radiofrequency, microwave, and laser ablation of liver tumors: time to move toward a tailored ablation technique? Hepatoma Res. 2015;1(2):52.
22. Hu KQ. Advances in clinical application of cryoablation therapy for hepatocellular carcinoma and metastatic liver tumor. J Clin Gastroenterol. 2014;48(10):830–6.
23. Delhaye C, Hendlisz A, Vouche M. Update on transarterial approaches to locoregional treatment in hepatocellular carcinoma. Curr Opin Oncol. 2019;31(4):339–45.
24. Sangro B, Iñarrairaegui M, Bilbao JI. Radioembolization for hepatocellular carcinoma. J Hepatol [Internet]. 2012;56(2):464–73. Available from: http://dx.doi.org/10.1016/j.jhep.2011.07.012
25. Chauhan N, Bukovcan J, Boucher E, Cosgrove D, Edeline J, Hamilton B, et al. Intra-Arterial TheraSphere Yttrium-90 Glass Microspheres in the Treatment of Patients With Unresectable Hepatocellular Carcinoma: Protocol for the STOP-HCC Phase 3 Randomized Controlled Trial. JMIR Res Protoc. 2018 Aug;7(8):e11234.
26. Reig M, Forner A, Rimola J, Ferrer-Fàbrega J, Burrel M, Garcia-Criado Á, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol [Internet]. 2022;76(3):681–93. Available from: https://doi.org/10.1016/j. jhep.2021.11.018
Published
2023-03-19
How to Cite
ALVES VAZ, Ana Luísa; MARTINS, Rui Miguel; TRALHÃO, José Guilherme.
LOCO-REGIONAL APPROACH IN THE TREATMENT OF HEPATOCELLULAR CARCINOMA.
Revista Portuguesa de Cirurgia, [S.l.], n. 54, p. 9-24, mar. 2023.
ISSN 2183-1165.
Available at: <https://revista.spcir.com/index.php/spcir/article/view/897>. Date accessed: 20 apr. 2024.
doi: https://doi.org/10.34635/rpc.897.
Issue
Section
Review Article
