PMID: 11500603

Issn Print: 0192-0790

Publication Date: 2001/09/01


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Unresectable Hepatocellular Carcinoma: The Need for an Individualized Multidisciplinary Approach

Adam E. Levy; Kris V. Kowdley

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Excerpt

The incidence of hepatocellular carcinoma (HCC) varies substantially from country to country; cirrhosis from any cause is associated with an increased risk of HCC. It has been estimated that the incidence of HCC may exceed 20% in patients with more than a 5-year history of cirrhosis. 1
Selection of an appropriate treatment of HCC must be based on the patient's Child-Turchotte-Pugh score and the radiographic estimate of tumor growth using the tumor, node, and metastasis staging. Potentially curative surgical interventions range from segmental resection to total hepatectomy with orthotopic liver transplant and should always be considered as possible first-line therapy for the treatment of HCC. Nonsurgical ablative procedures are generally reserved for patients with unresectable tumor or those patients who are awaiting transplant. These therapies include percutaneous ethanol injection (PEI), radiofrequency thermal ablation (RFA), cryoablation therapy, and transarterial chemoembolization (TACE).

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