The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma
Autor: | Eve Simoneau, Murad Aljiffry, N. Molla, David Valenti, N. Almenieir, Peter Metrakos, Louis-Martin Boucher, Mazen Hassanain |
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Rok vydání: | 2014 |
Předmět: |
Interventional radiology
medicine.medical_specialty Tare weight medicine.diagnostic_test business.industry Radiofrequency ablation medicine.medical_treatment Microwave ablation Cryoablation hepatocellular carcinoma embolization Liver transplantation ablation Surgery law.invention Systematic review law medicine drug-eluting beads Radiology Embolization business Review Articles liver biopsy |
Zdroj: | Current Oncology Volume 21 Issue 3 Pages 1829-492 |
ISSN: | 1718-7729 |
Popis: | Hepatocellular carcinoma (hcc) is one of the most common causes of cancer-related death worldwide. Overall, liver transplantation and resection are the only available treatments with potential for cure. Various locoregional therapies are widely used to manage patients with advanced hcc or as a bridging therapy for patients with early and intermediate disease. This article reviews and evaluates the role of interventional radiology in the management of such cases by assessing various aspects of each method, such as effect on rates of survival, recurrence, tumour response, and complications. A systemic search of PubMed, medline, Ovid Medline In-Process, and the Cochrane Database of Systematic Reviews retrieved all related scientific papers for review. Needle core biopsy is a highly sensitive, specific, and accurate method for hcc grading. Portal-vein embolization provides adequate expansion of the future liver remnant, making more patients eligible for resection. In focal or multifocal unresectable early-stage disease, radiofrequency ablation tops all other thermoablative methods. However, microwave ablation is preferred in large tumours and in patients with Child&ndash Pugh B disease. Cryoablation is preferred in recurrent disease and in patients who are poor candidates for anesthesia. Of the various transarterial modalities&mdash transarterial chemoembolization (tace), drug-eluting beads, and transarterial radio-embolization (tare)&mdash tace is the method of choice in Child&ndash Pugh A disease, and tare is the method of choice in hcc cases with portal vein thrombosis. The existing data support the importance of a multidisciplinary approach in hcc management. Large randomized controlled studies are needed to provide clear indication guidelines for each method. |
Databáze: | OpenAIRE |
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