Surgical treatment of hepatocellular carcinoma in cirrhosis
| Autor: | R. Dalla Valle, D. Borie, L. Hannoun, G. C. Botta |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Liver Cirrhosis
medicine.medical_specialty Cirrhosis Carcinoma Hepatocellular medicine.medical_treatment Spiral computed tomography scan Liver transplantation medicine Humans Chemoembolization Therapeutic Surgical treatment Neoplasm Staging Hepatology business.industry Patient Selection Liver Neoplasms Palliative Care Gastroenterology Cancer medicine.disease Prognosis Liver Transplantation Treatment Outcome Hepatocellular carcinoma Functional status Radiology Percutaneous ethanol injection business |
| Zdroj: | Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 32(4) |
| ISSN: | 1590-8658 |
| Popis: | Hepatocellular carcinoma is one of the most frequent forms of cancer worldwide and its diagnosis and treatment have changed substantially during the last few years. Recent advances in ultrasonography, spiral computed tomography scan and nuclear magnetic resonance have further simplified the diagnostic approach to hepatocellular carcinoma. Ultrasonography is the reference examination, giving a wide variety of information on tumour size, location, relationship with portal and hepatic veins and splanchnic haemodynamics. Surgical resection and liver transplantation can both be defined as curative treatment while other techniques such as percutaneous ethanol injection and chemoembolization must be considered as palliative. Therapeutic strategies for hepatocellular carcinoma are based upon data concerning the characteristics of the tumour, the functional status of non-tumoural liver parenchyma and patients' general conditions. Surgery of hepatocellular carcinoma in cirrhotic liver is mainly restricted by lack of functional hepatic reserve and by the limited capacity of hepatic regeneration. The best surgical results are obtained in early tumoural stages which generally need limited resection. Nevertheless, major liver resections have a specific role in selected cases. Recurrence rate after surgical resection is high and is related to a large number of factors. For this reason, liver transplantation, removing at the same time, the tumour and the underlying disease, is considered, theoretically, the best treatment for hepatocellular carcinoma, but its role is still debated and limited by difficult organ sharing. Integration of present therapeutic schemes are under evaluation with promising preliminary results. |
| Databáze: | OpenAIRE |
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