TY - JOUR
T1 - Current surgical treatment strategies for hepatocellular carcinoma in North America
AU - Khan, Adeel S.
AU - Fowler, Kathryn J.
AU - Chapman, William C.
N1 - Publisher Copyright:
© 2014 Baishideng Publishing Group Inc. All rights reserved.
PY - 2014/11/7
Y1 - 2014/11/7
N2 - 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.
AB - 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.
KW - Hepatocellular carcinoma
KW - Liver resection
KW - Liver transplantation
KW - Radiofrequency ablation
KW - Transarterial chemoembolization
UR - http://www.scopus.com/inward/record.url?scp=84912126680&partnerID=8YFLogxK
U2 - 10.3748/wjg.v20.i41.15007
DO - 10.3748/wjg.v20.i41.15007
M3 - Review article
C2 - 25386049
AN - SCOPUS:84912126680
SN - 1007-9327
VL - 20
SP - 15007
EP - 15017
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
IS - 41
ER -