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Recent advances in the treatment of hepatocellular carcinoma

Padhya, Kunjali T.; Marrero, Jorge A.; Singal, Amit G.

Current Opinion in Gastroenterology: May 2013 - Volume 29 - Issue 3 - p 285–292
doi: 10.1097/MOG.0b013e32835ff1cf
LIVER: Editor by Don Rockey
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Purpose of review To provide an up-to-date summary of the recent advances in therapies for hepatocellular carcinoma (HCC).

Recent findings Surgical resection, liver transplantation, and local ablative therapies such as radiofrequency ablation offer potential cure for tumors detected at an early stage in well selected patients. The role of adjuvant or neoadjuvant therapy is being investigated, but there is no clear evidence supporting its routine use currently. Some have proposed expanding size criteria for transplantation or downstaging tumors detected beyond an early stage, although benefits must be weighed against harms to others on the waiting list. For intermediate-stage HCC, transarterial chemoembolization is the mainstay of treatment, although there is increasing evidence supporting a role for transarterial radioembolization. For advanced HCC, sorafenib is the only systemic therapy to significantly prolong survival in patients with Child A cirrhosis and good performance status. Ongoing trials are evaluating the role of other targeted therapies in patients with advanced HCC.

Summary There have been advances in HCC treatment options over the last couple of years and there are now potential therapies for most patients with any stage of disease. Treatment decisions must be individualized after accounting for factors such as degree of liver dysfunction and patient performance status.

Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, USA

Correspondence to Amit G. Singal, MD, MS, Dedman Scholar of Clinical Care, Division of Gastroenterology, University of Texas Southwestern, 5959 Harry Hines Boulevard, POB 1, Suite 420, Dallas, TX 75390-8887, USA. Tel: +1 214 645 6029; fax: +1 214 645 6294; e-mail: amit.singal@utsouthwestern.edu

© 2013 Lippincott Williams & Wilkins, Inc.