Local-regional treatment of hepatocellular carcinoma

Riccardo Lencioni, Laura Crocetti

Research output: Contribution to journalArticle

211 Citations (Scopus)

Abstract

Local-regional treatments play a key role in the management of hepatocellular carcinoma (HCC). Image-guided tumor ablation is recommended in patients with early-stage HCC when surgical options are precluded and can replace resection in selected patients. Radiofrequency (RF) ablation has shown superior anticancer effects and greater survival benefit with respect to the seminal percutaneous technique, ethanol injection, in meta-analyses of randomized controlled trials and is currently established as the standard method for local tumor treatment. Novel thermal and nonthermal techniques for tumor ablation, including microwave ablation and irreversible electroporation, seem to have potential to overcome the limitations of RF ablation and warrant further clinical investigation. Transcatheter arterial chemoembolization (TACE) is the standard of care for patients with asymptomatic noninvasive multinodular tumors in intermediate-stage disease. Embolic microspheres that have the ability to release a drug in a controlled and sustained fashion have been shown to substantially increase the safety and efficacy of TACE in comparison to conventional ethiodized oil -based regimens. The available data for radioembolization with yttrium 90 suggest that this is a potential new option for patients with HCC, and future studies should be devoted to assessments of the role of radioembolization in the treatment algorithm for HCC.

Original languageEnglish (US)
Pages (from-to)43-58
Number of pages16
JournalRadiology
Volume262
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

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Hepatocellular Carcinoma
Neoplasms
Ablation Techniques
Ethiodized Oil
Yttrium
Electroporation
Therapeutics
Standard of Care
Microwaves
Microspheres
Meta-Analysis
Ethanol
Randomized Controlled Trials
Hot Temperature
Safety
Injections
Survival

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Local-regional treatment of hepatocellular carcinoma. / Lencioni, Riccardo; Crocetti, Laura.

In: Radiology, Vol. 262, No. 1, 01.2012, p. 43-58.

Research output: Contribution to journalArticle

Lencioni, Riccardo ; Crocetti, Laura. / Local-regional treatment of hepatocellular carcinoma. In: Radiology. 2012 ; Vol. 262, No. 1. pp. 43-58.
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