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Hepatocellular Carcinoma: Current Management and Future Development—Improved Outcomes with Surgical Resection

Currently, surgical resection is the treatment strategy offering the best long-term outcomes in patients with hepatocellular carcinoma (HCC). Especially for advanced HCC, surgical resection is the only strategy that is potentially curative, and the indications for surgical resection have expanded co...

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Autores principales: Kishi, Yoji, Hasegawa, Kiyoshi, Sugawara, Yasuhiko, Kokudo, Norihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE-Hindawi Access to Research 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170840/
https://www.ncbi.nlm.nih.gov/pubmed/21994868
http://dx.doi.org/10.4061/2011/728103
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author Kishi, Yoji
Hasegawa, Kiyoshi
Sugawara, Yasuhiko
Kokudo, Norihiro
author_facet Kishi, Yoji
Hasegawa, Kiyoshi
Sugawara, Yasuhiko
Kokudo, Norihiro
author_sort Kishi, Yoji
collection PubMed
description Currently, surgical resection is the treatment strategy offering the best long-term outcomes in patients with hepatocellular carcinoma (HCC). Especially for advanced HCC, surgical resection is the only strategy that is potentially curative, and the indications for surgical resection have expanded concomitantly with the technical advances in hepatectomy. A major problem is the high recurrence rate even after curative resection, especially in the remnant liver. Although repeat hepatectomy may prolong survival, the suitability may be limited due to multiple tumor recurrence or background liver cirrhosis. Multimodality approaches combining other local ablation or systemic therapy may help improve the prognosis. On the other hand, minimally invasive, or laparoscopic, hepatectomy has become popular over the last decade. Although the short-term safety and feasibility has been established, the long-term outcomes have not yet been adequately evaluated. Liver transplantation for HCC is also a possible option. Given the current situation of donor shortage, however, other local treatments should be considered as the first choice as long as liver function is maintained. Non-transplant treatment as a bridge to transplantation also helps in decreasing the risk of tumor progression or death during the waiting period. The optimal timing for transplantation after HCC recurrence remains to be investigated.
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spelling pubmed-31708402011-10-12 Hepatocellular Carcinoma: Current Management and Future Development—Improved Outcomes with Surgical Resection Kishi, Yoji Hasegawa, Kiyoshi Sugawara, Yasuhiko Kokudo, Norihiro Int J Hepatol Review Article Currently, surgical resection is the treatment strategy offering the best long-term outcomes in patients with hepatocellular carcinoma (HCC). Especially for advanced HCC, surgical resection is the only strategy that is potentially curative, and the indications for surgical resection have expanded concomitantly with the technical advances in hepatectomy. A major problem is the high recurrence rate even after curative resection, especially in the remnant liver. Although repeat hepatectomy may prolong survival, the suitability may be limited due to multiple tumor recurrence or background liver cirrhosis. Multimodality approaches combining other local ablation or systemic therapy may help improve the prognosis. On the other hand, minimally invasive, or laparoscopic, hepatectomy has become popular over the last decade. Although the short-term safety and feasibility has been established, the long-term outcomes have not yet been adequately evaluated. Liver transplantation for HCC is also a possible option. Given the current situation of donor shortage, however, other local treatments should be considered as the first choice as long as liver function is maintained. Non-transplant treatment as a bridge to transplantation also helps in decreasing the risk of tumor progression or death during the waiting period. The optimal timing for transplantation after HCC recurrence remains to be investigated. SAGE-Hindawi Access to Research 2011 2011-06-23 /pmc/articles/PMC3170840/ /pubmed/21994868 http://dx.doi.org/10.4061/2011/728103 Text en Copyright © 2011 Yoji Kishi et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Kishi, Yoji
Hasegawa, Kiyoshi
Sugawara, Yasuhiko
Kokudo, Norihiro
Hepatocellular Carcinoma: Current Management and Future Development—Improved Outcomes with Surgical Resection
title Hepatocellular Carcinoma: Current Management and Future Development—Improved Outcomes with Surgical Resection
title_full Hepatocellular Carcinoma: Current Management and Future Development—Improved Outcomes with Surgical Resection
title_fullStr Hepatocellular Carcinoma: Current Management and Future Development—Improved Outcomes with Surgical Resection
title_full_unstemmed Hepatocellular Carcinoma: Current Management and Future Development—Improved Outcomes with Surgical Resection
title_short Hepatocellular Carcinoma: Current Management and Future Development—Improved Outcomes with Surgical Resection
title_sort hepatocellular carcinoma: current management and future development—improved outcomes with surgical resection
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170840/
https://www.ncbi.nlm.nih.gov/pubmed/21994868
http://dx.doi.org/10.4061/2011/728103
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