Multidisciplinary strategies to improve treatment outcomes in hepatocellular carcinoma: A European perspective

Massimo Colombo, Jean Luc Raoul, Riccardo Lencioni, Peter R. Galle, Jessica Zucman-Rossi, Rafael Bañares, Daniel Seehofer, Peter Neuhaus, Philip Johnson

Research output: Contribution to journalReview article

26 Scopus citations

Abstract

Hepatocellular carcinoma (HCC) is a complex disease with a poor prognosis. Incidence and mortality rates are increasing in many geographical regions, indicating a need for better management strategies. Among several risk factors for HCC, the most common are cirrhosis because of chronic hepatitis B virus or hepatitis C virus infection and alcohol consumption, obesity, and diabetes. In some patients, combined risk factors present additional challenges to the prevention and treatment of HCC. Screening and surveillance of high-risk populations varies widely by geographic regions, and access to optimal surveillance is critical for early diagnosis. The treatment choice for HCC depends on the cancer stage, patient performance status, and liver function and requires a multidisciplinary approach and close cooperation among specialists for the best patient outcomes. Despite advances in surgical treatments and locoregional therapies, recurrence and liver failure remain significant challenges. The pathogenesis of HCC is a multistep and complex process, wherein angiogenesis plays an important role. The multikinase inhibitor sorafenib is the only approved targeted agent for advanced HCC, although promising results have been obtained with other targeted agents and combinations, and the results of ongoing trials are eagerly awaited. Clinical trials with rigorous study designs, including molecular classification and validation of new molecular biomarkers, are required to improve the personalized treatment of HCC. This article provides an overview of HCC and was developed through a review of relevant literature, clinical trial data, and updated clinical guidelines.

Original languageEnglish (US)
Pages (from-to)639-651
Number of pages13
JournalEuropean Journal of Gastroenterology and Hepatology
Volume25
Issue number6
DOIs
StatePublished - Jun 2013

Keywords

  • brivanib
  • everolimus
  • hepatocellular carcinoma
  • linifanib
  • radiofrequency ablation
  • ramucirumab
  • sorafenib
  • transarterial chemoembolization
  • transplantation

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Colombo, M., Raoul, J. L., Lencioni, R., Galle, P. R., Zucman-Rossi, J., Bañares, R., Seehofer, D., Neuhaus, P., & Johnson, P. (2013). Multidisciplinary strategies to improve treatment outcomes in hepatocellular carcinoma: A European perspective. European Journal of Gastroenterology and Hepatology, 25(6), 639-651. https://doi.org/10.1097/MEG.0b013e32835e33bb