Guidelines For Clinical Practice
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 7, 2011; 17(13): 1685-1689
Published online Apr 7, 2011. doi: 10.3748/wjg.v17.i13.1685
Therapeutic options for intermediate-advanced hepatocellular carcinoma
Zong-Ming Zhang, Jin-Xing Guo, Zi-Chao Zhang, Nan Jiang, Zhen-Ya Zhang, Li-Jie Pan
Zong-Ming Zhang, Jin-Xing Guo, Zi-Chao Zhang, Nan Jiang, Zhen-Ya Zhang, Li-Jie Pan, Department of General Surgery, Digestive Medical Center, The First Affiliated Hospital, School of Medicine, Tsinghua University, Beijing 100016, China
Author contributions: Zhang ZM designed and wrote the paper; and all other authors revised and approved the final version of the paper.
Supported by the National Natural Science Foundation of China, No. 81071996
Correspondence to: Zong-Ming Zhang, MD, PhD, Professor, Department of General Surgery, Digestive Medical Center, The First Affiliated Hospital, School of Medicine, Tsinghua University, Beijing 100016, China. zhangzongming@mail.tsinghua.edu.cn
Telephone: +86-10-64372362 Fax: +86-10-64361322
Received: December 6, 2010
Revised: January 18, 2011
Accepted: January 25, 2011
Published online: April 7, 2011
Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignancies, ranking the sixth in the world, with 55% of cases occurring in China. Usually, patients with HCC did not present until the late stage of the disease, thus limiting their therapeutic options. Although surgical resection is a potentially curative modality for HCC, most patients with intermediate-advanced HCC are not suitable candidates. The current therapeutic modalities for intermediate-advanced HCC include: (1) surgical procedures, such as radical resection, palliative resection, intraoperative radiofrequency ablation or cryosurgical ablation, intraoperative hepatic artery and portal vein chemotherapeutic pump placement, two-stage hepatectomy and liver transplantation; (2) interventional treatment, such as transcatheter arterial chemoembolization, portal vein embolization and image-guided locoregional therapies; and (3) molecularly targeted therapies. So far, how to choose the therapeutic modalities remains controversial. Surgeons are faced with the challenge of providing the most appropriate treatment for patients with intermediate-advanced HCC. This review focuses on the optional therapeutic modalities for intermediate-advanced HCC.

Keywords: Hepatocellular carcinoma, Intermediate-advanced, Surgical procedure, Interventional treatment, Molecularly targeted therapy