A review and update of treatment options and controversies in the management of hepatocellular carcinoma

Mashaal Dhir, Alyson A. Melin, Jeffrey Douaiher, Chi Lin, Weining Ken Zhen, Shahid M. Hussain, Jean Francois H. Geschwind, Maria B.Majella Doyle, Ghassan K. Abou-Alfa, Chandrakanth Are

Research output: Contribution to journalReview article

103 Scopus citations

Abstract

Objective: To review the current management, outline recent advances and address controversies in the management of hepatocellular carcinoma (HCC). Summary of Background data: The treatment of HCC is multidisciplinary involving hepatologists, surgeons, medical oncologists, radiation oncologists, radiologists, interventional radiologists, and other disciplines. Each of these disciplines brings its unique perspective and differing opinions that add to controversies in the management of HCC. Methods: A focused literature review was performed to identify recent studies on the management of HCC and thereby summarize relevant information on the various therapeutic modalities and controversies involved in the treatment of HCC. Results: The main treatment algorithms continue to rely on hepatic resection or transplantation with controversies involving patients harboring early stage disease and borderline hepatic function. The other treatment strategies include locoregional therapies, radiation, and systemic therapy used alone or in combination with other treatment modalities. Recent advances in locoregional therapies, radiation, and systemic therapies have provided better therapeutic options with curative intent potential for some locoregional therapies. Further refinements in combination therapies such as algorithms consisting of locoregional therapies and systemic or radiation therapies are likely to add additional options and improve survival. Conclusions: The management of HCC has witnessed significant strides with advances in existing options and introduction of several new treatment modalities of various combinations. Further refinements in these treatment options combined with enrollment in clinical trials are essential to improve the management and outcomes of patients with HCC.

Original languageEnglish (US)
Pages (from-to)1112-1125
Number of pages14
JournalAnnals of surgery
Volume263
Issue number6
DOIs
StatePublished - 2016

Keywords

  • Ablation
  • Hepatocellular carcinoma
  • Locoregional therapies
  • Management
  • Radiation
  • Resection
  • Systemic therapies
  • Transplant

ASJC Scopus subject areas

  • Surgery

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    Dhir, M., Melin, A. A., Douaiher, J., Lin, C., Zhen, W. K., Hussain, S. M., Geschwind, J. F. H., Doyle, M. B. M., Abou-Alfa, G. K., & Are, C. (2016). A review and update of treatment options and controversies in the management of hepatocellular carcinoma. Annals of surgery, 263(6), 1112-1125. https://doi.org/10.1097/SLA.0000000000001556