December 8, 2017

Nonsurgical options for localized hepatocellular carcinoma


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Volume 10, Issue 4
October 2017
Pages 103–106


John Ha M.D., Robert J. Wong M.D., M.S.

First published: 31 October 2017

First published: 31 October 2017 Full publication history

DOI: 10.1002/cld.662 View/save citation

Potential conflict of interest: Nothing to report.


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Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths in the United States. With its current trend, HCC is projected to become the third leading cause of cancer-related deaths in the United States by 2030.[1] Currently, more than 55% of HCC cases are diagnosed beyond localized disease, and the majority do not receive definitive curative therapies, such as surgical resection or liver transplantation.[1, 2] Curative therapies are mainly reserved for patients with localized disease or those within Milan criteria. However, many nonsurgical treatment options are still available to patients with unresectable, advanced stage HCC (Table 1). Although there are many options for locoregional or systemic therapies in the management of unresectable HCC, this review will focus specifically on transarterial radioembolization (TARE), radiofrequency (RFA)/microwave ablation (MWA), stereotactic body radiation therapy (SBRT), systemic therapy, and hospice/supportive medicine. It is important to note that the approach for HCC treatment is variable and dependent on many factors, such as medical expertise, performance status, tumor stage and location, and degree of liver dysfunction. Therefore, utilizing multidisciplinary teams may provide the best option for developing a treatment plan.

Table 1. Curative Versus Noncurative Therapies for HCC


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