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World J Gastroenterol. Jan 21, 2023; 29(3): 413-424
Published online Jan 21, 2023. doi: 10.3748/wjg.v29.i3.413
Salvage locoregional therapies for recurrent hepatocellular carcinoma
Cody R Criss, Mina S Makary
Cody R Criss, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, United States
Mina S Makary, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio 43210, United States
Author contributions: Criss CR, and Makary MS contributed to the preparation of the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest associated with the contributions to this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mina S Makary, MD, Assistant Professor, Attending Doctor, Director, Radiology, The Ohio State University Wexner Medical Center, 395 West 12th Ave, 4th Floor, Columbus, Ohio 43210, United States. mina.makary@osumc.edu
Received: September 4, 2022
Peer-review started: September 4, 2022
First decision: November 5, 2022
Revised: November 20, 2022
Accepted: January 2, 2023
Article in press: January 2, 2023
Published online: January 21, 2023
Processing time: 130 Days and 5.4 Hours
Abstract

Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death worldwide. Despite the advent of screening efforts and algorithms to stratify patients into appropriate treatment strategies, recurrence rates remain high. In contrast to first-line treatment for HCC, which relies on several factors, including clinical staging, tumor burden, and liver function, there is no consensus or general treatment recommendations for recurrent HCC (R-HCC). Locoregional therapies include a spectrum of minimally invasive liver-directed treatments which can be used as either curative or neoadjuvant therapy for HCC. Herein, we provide a comprehensive review of recent evidence using salvage loco-regional therapies for R-HCC after failed curative-intent.

Keywords: Recurrent hepatocellular carcinoma; Locoregional therapy; Transarterial chemoembolization; Transarterial embolization; Transarterial radioembolization; Ablation; Salvage therapy

Core Tip: Management of recurrent hepatocellular carcinoma (R-HCC) includes surgical resection, systemic treatment, or locoregional therapies including ablation, transarterial chemoembolization, or radioembolization, and stereotactic body radiation therapy. In the setting of recurrence, locoregional therapies offer unique advantages over surgery for select patients. Recent investigations have also highlighted the potential of combining locoregional therapies or adding systemic retreatments for R-HCC.