Specific Liver Lesions
Hepatocellular Carcinoma
(HCC – also known as hepatoma):
The primary treatment for hepatocellular carcinoma
(HCC – also known as hepatoma) is surgical removal, often by means of a complete liver removal and liver transplantation from an unrelated donor. Surgical removal has curative potential, particularly for patients with localized disease who do not have to wait too long for their donated liver (1-3).Unfortunately only a minority of HCC patients are candidates for hepatectomy and liver transplantation, and to make matters worse, even those who are eligible may progress to inoperability, while they wait for a donated liver to become available, as the waiting time may exceed a year (2).
To address the potential for tumor progression and mortality caused by delayed transplantation in otherwise operable patients, “bridge” therapies such as radiofrequency ablation or chemoembolization, even though not typically regarded as curative, have been applied as a means to delay tumor progression until removal of the malignant liver and transplantation may occur (11).
In patients where surgical removal is not possible, HCC patients have received modest life extension from the nonsurgical ablative therapies and local radiotherapy
(10, 13, 15 -17).High dose radiotherapy has created prolonged responses and some long term disease-free survivals in HCC patients (15 -17), though relapse at the treated site remains common due to the often limited dose of radiation that may be safely applied, leaving room for further improvement.
|
