Current surgical treatment strategies for hepatocellular carcinoma in North America
Identifieur interne : 002626 ( Pmc/Curation ); précédent : 002625; suivant : 002627Current surgical treatment strategies for hepatocellular carcinoma in North America
Auteurs : Adeel S. Khan ; Kathryn J. Fowler ; William C. ChapmanSource :
- World Journal of Gastroenterology : WJG [ 1007-9327 ] ; 2014.
Abstract
Hepatocellular carcinoma (HCC) is an aggressive tumor that often occurs in the setting of chronic liver disease. Many patients do not initially manifest any symptoms of HCC and present late when cure with surgical resection or transplantation is no longer possible. For this reason, patients at high risk for developing HCC are subjected to frequent screening processes. The surgical management of HCC is complex and requires an inter-disciplinary approach. Hepatic resection is the treatment of choice for HCC in patients without cirrhosis and is indicated in some patients with early cirrhosis (Child-Pugh A). Liver transplantation has emerged in the past decade as the standard of care for patients with cirrhosis and HCC meeting Milan criteria and in select patients with HCC beyond Milan criteria. Loco-regional therapy with transarterial chemoembolization, transarterial embolization, radiofrequency ablation and other similar local treatments can be used as neo-adjuvant therapy to downstage HCC to within Milan criteria or as a bridge to transplantation in patients on transplant wait list.
Url:
DOI: 10.3748/wjg.v20.i41.15007
PubMed: 25386049
PubMed Central: 4223234
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<series><title level="j">World Journal of Gastroenterology : WJG</title>
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<front><div type="abstract" xml:lang="en"><p>Hepatocellular carcinoma (HCC) is an aggressive tumor that often occurs in the setting of chronic liver disease. Many patients do not initially manifest any symptoms of HCC and present late when cure with surgical resection or transplantation is no longer possible. For this reason, patients at high risk for developing HCC are subjected to frequent screening processes. The surgical management of HCC is complex and requires an inter-disciplinary approach. Hepatic resection is the treatment of choice for HCC in patients without cirrhosis and is indicated in some patients with early cirrhosis (Child-Pugh A). Liver transplantation has emerged in the past decade as the standard of care for patients with cirrhosis and HCC meeting Milan criteria and in select patients with HCC beyond Milan criteria. Loco-regional therapy with transarterial chemoembolization, transarterial embolization, radiofrequency ablation and other similar local treatments can be used as neo-adjuvant therapy to downstage HCC to within Milan criteria or as a bridge to transplantation in patients on transplant wait list.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">World J Gastroenterol</journal-id>
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<issn pub-type="ppub">1007-9327</issn>
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<publisher><publisher-name>Baishideng Publishing Group Inc</publisher-name>
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<title-group><article-title>Current surgical treatment strategies for hepatocellular carcinoma in North America</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Khan</surname>
<given-names>Adeel S</given-names>
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<contrib contrib-type="author"><name><surname>Fowler</surname>
<given-names>Kathryn J</given-names>
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<contrib contrib-type="author"><name><surname>Chapman</surname>
<given-names>William C</given-names>
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<aff>Adeel S Khan, Department of General and Vascular Surgery, Aurora Bay Care Medical Center, Greenbay, WI 54311, United States</aff>
<aff>Kathryn J Fowler, Department of Radiology, Washington University School of Medicine, St Louis, MO 63110, United States</aff>
<aff>William C Chapman, Department of Surgery, Section of Abdominal Transplant, Washington University School of Medicine, St Louis, MO 63110, United States</aff>
</contrib-group>
<author-notes><fn><p>Author contributions: Khan AS and Chapman WC wrote the paper; Fowler KJ contributed with radiology images and to the writing of the section on diagnosis.</p>
<p>Correspondence to: Adeel S Khan, MD, Assistant Clinical Professor of Surgery, Department of General and Vascular Surgery, Aurora Bay Care Medical Center, 2845 Greenbrier Rd, Greenbay, WI 54311, United States. <email>adeel.khan@aurora.org</email>
</p>
<p>Telephone: +1-906-2900348 Fax: +1-715-7358921</p>
</fn>
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<pub-date pub-type="ppub"><day>7</day>
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<volume>20</volume>
<issue>41</issue>
<fpage>15007</fpage>
<lpage>15017</lpage>
<history><date date-type="received"><day>28</day>
<month>4</month>
<year>2014</year>
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<date date-type="rev-recd"><day>27</day>
<month>6</month>
<year>2014</year>
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<date date-type="accepted"><day>24</day>
<month>7</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>©2014 Baishideng Publishing Group Inc. All rights reserved.</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract><p>Hepatocellular carcinoma (HCC) is an aggressive tumor that often occurs in the setting of chronic liver disease. Many patients do not initially manifest any symptoms of HCC and present late when cure with surgical resection or transplantation is no longer possible. For this reason, patients at high risk for developing HCC are subjected to frequent screening processes. The surgical management of HCC is complex and requires an inter-disciplinary approach. Hepatic resection is the treatment of choice for HCC in patients without cirrhosis and is indicated in some patients with early cirrhosis (Child-Pugh A). Liver transplantation has emerged in the past decade as the standard of care for patients with cirrhosis and HCC meeting Milan criteria and in select patients with HCC beyond Milan criteria. Loco-regional therapy with transarterial chemoembolization, transarterial embolization, radiofrequency ablation and other similar local treatments can be used as neo-adjuvant therapy to downstage HCC to within Milan criteria or as a bridge to transplantation in patients on transplant wait list.</p>
</abstract>
<kwd-group><kwd>Hepatocellular carcinoma</kwd>
<kwd>Liver transplantation</kwd>
<kwd>Liver resection</kwd>
<kwd>Transarterial chemoembolization</kwd>
<kwd>Radiofrequency ablation</kwd>
</kwd-group>
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