Percutaneous Therapies for Hepatocellular Carcinoma: Evolution of Liver Directed Therapies

Huber, Timothy C.; Bochnakova, Teodora; Koethe, Yilun; Park, Brian; Farsad, Khashayar

doi:10.2147/jhc.s268300

Cited by 19 publications

(29 citation statements)

References 96 publications

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“…Thermal ablation constitutes a first-line treatment with curative intent in patients with small, very-early and early stage HCCs, alongside surgical excision and orthotopic liver transplantation [ 4 , 208 ]. The principle of ablation is the application of thermal energy via an electrode or antenna placed in the tumor, with subsequent heating of the adjacent tumor cells and induction of necrosis [ 209 ]. Usually, a contrast-enhanced CT scan is performed immediately after the ablation procedure in order to confirm a “safety” necrotic margin of at least 0.5 cm around the ablated tumor ( Figure 15 ).…”

Section: Imaging Assessment Of Hcc Following Percutaneous Locoregiona...mentioning

confidence: 99%

Current Imaging Diagnosis of Hepatocellular Carcinoma

Chartampilas

Rafailidis

Georgopoulou

et al. 2022

Cancers

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Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer related death worldwide. Radiology has traditionally played a central role in HCC management, ranging from screening of high-risk patients to non-invasive diagnosis, as well as the evaluation of treatment response and post-treatment follow-up. From liver ultrasonography with or without contrast to dynamic multiple phased CT and dynamic MRI with diffusion protocols, great progress has been achieved in the last decade. Throughout the last few years, pathological, biological, genetic, and immune-chemical analyses have revealed several tumoral subtypes with diverse biological behavior, highlighting the need for the re-evaluation of established radiological methods. Considering these changes, novel methods that provide functional and quantitative parameters in addition to morphological information are increasingly incorporated into modern diagnostic protocols for HCC. In this way, differential diagnosis became even more challenging throughout the last few years. Use of liver specific contrast agents, as well as CT/MRI perfusion techniques, seem to not only allow earlier detection and more accurate characterization of HCC lesions, but also make it possible to predict response to treatment and survival. Nevertheless, several limitations and technical considerations still exist. This review will describe and discuss all these imaging modalities and their advances in the imaging of HCC lesions in cirrhotic and non-cirrhotic livers. Sensitivity and specificity rates, method limitations, and technical considerations will be discussed.

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Section: Imaging Assessment Of Hcc Following Percutaneous Locoregiona...mentioning

confidence: 99%

Current Imaging Diagnosis of Hepatocellular Carcinoma

Chartampilas

Rafailidis

Georgopoulou

et al. 2022

Cancers

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“…They penetrate through biologic materials with high impedance, such as dehydrated or charred tissue. In other terms, MWA can deliver high temperatures for longer time, thus improving ablation efficacy by increasing thermal conduction into the surrounding tissue [11] and allowing faster treatments of larger tumors compared to RFA [13].…”

Section: Ablation Techniquesmentioning

confidence: 99%

Percutaneous and Laparoscopic-Assisted Ablation of Hepatocellular Carcinoma

Cillo

Lanari

Masutti

et al. 2022

Hepatocellular Carcinoma

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Beside thermal ablation, potentially curative therapies for HCC include liver resection (LR) and liver transplantation (LT). Owing to the absence of randomized trials comparing the three approaches, when selecting the best option, it is recommended to evaluate the main independent clinical prognostic factors of HCC: tumor burden, vascular invasion, extrahepatic spread, liver function, portal hypertension, and patient conditions (Eastern Cooperative Oncology Group [ECOG] Performance Status) [1]. Both

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“…The main treatment options for HCC include definitive therapies, such as whole or partial hepatectomy and liver transplant. When surgical treatment is not an option, chemical, radiofrequency, microwave ablation, or transarterial chemoembolization are performed [ 12 , 13 ]. Liver transplantation and ablation are potentially curative, but typically only early-stage patients benefit from this type of treatment [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Tumor Microenvironment of Hepatocellular Carcinoma: Challenges and Opportunities for New Treatment Options

Sas

Cendrowicz

Weinhäuser

et al. 2022

IJMS

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The prevalence of liver cancer is constantly rising, with increasing incidence and mortality in Europe and the USA in recent decades. Among the different subtypes of liver cancers, hepatocellular carcinoma (HCC) is the most commonly diagnosed liver cancer. Besides advances in diagnosis and promising results of pre-clinical studies, HCC remains a highly lethal disease. In many cases, HCC is an effect of chronic liver inflammation, which leads to the formation of a complex tumor microenvironment (TME) composed of immune and stromal cells. The TME of HCC patients is a challenge for therapies, as it is involved in metastasis and the development of resistance. However, given that the TME is an intricate system of immune and stromal cells interacting with cancer cells, new immune-based therapies are being developed to target the TME of HCC. Therefore, understanding the complexity of the TME in HCC will provide new possibilities to design novel and more effective immunotherapeutics and combinatorial therapies to overcome resistance to treatment. In this review, we describe the role of inflammation during the development and progression of HCC by focusing on TME. We also describe the most recent therapeutic advances for HCC and possible combinatorial treatment options.

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Percutaneous Therapies for Hepatocellular Carcinoma: Evolution of Liver Directed Therapies

Cited by 19 publications

References 96 publications

Current Imaging Diagnosis of Hepatocellular Carcinoma

Current Imaging Diagnosis of Hepatocellular Carcinoma

Percutaneous and Laparoscopic-Assisted Ablation of Hepatocellular Carcinoma

Tumor Microenvironment of Hepatocellular Carcinoma: Challenges and Opportunities for New Treatment Options

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