Mina S Makary, MD, Assistant Professor, Attending Doctor, Director, Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, 395 W. 12th Ave, 4th Floor, Columbus, OH 43210, United States. mina.makary@osumc.edu
Research Domain of This Article
Oncology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. May 27, 2022; 14(5): 885-895 Published online May 27, 2022. doi: 10.4254/wjh.v14.i5.885
Emerging curative-intent minimally-invasive therapies for hepatocellular carcinoma
Kylie E Zane, Paul B Nagib, Sajid Jalil, Khalid Mumtaz, Mina S Makary
Kylie E Zane, Paul B Nagib, College of Medicine, The Ohio State University, Columbus, OH 43210, United States
Sajid Jalil, Khalid Mumtaz, Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Mina S Makary, Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Author contributions: All authors contributed to the preparation of the manuscript.
Conflict-of-interest statement: The authors declare they have no conflicts of interest
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, Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, 395 W. 12th Ave, 4th Floor, Columbus, OH 43210, United States. mina.makary@osumc.edu
Received: December 22, 2021 Peer-review started: December 22, 2021 First decision: February 8, 2022 Revised: February 20, 2022 Accepted: April 25, 2022 Article in press: April 25, 2022 Published online: May 27, 2022
Abstract
Hepatocellular carcinoma (HCC) is the most common cause of liver malignancy and the fourth leading cause of cancer deaths universally. Cure can be achieved for early stage HCC, which is defined as 3 or fewer lesions less than or equal to 3 cm in the setting of Child-Pugh A or B and an ECOG of 0. Patients outside of these criteria who can be down-staged with loco-regional therapies to resection or liver transplantation (LT) also achieve curative outcomes. Traditionally, surgical resection, LT, and ablation are considered curative therapies for early HCC. However, results from recently conducted LEGACY study and DOSISPHERE trial demonstrate that transarterial radio-embolization has curative outcomes for early HCC, leading to its recent incorporation into the Barcelona clinic liver criteria guidelines for early HCC. This review is based on current evidence for curative-intent loco-regional therapies including radioembolization for early-stage HCC.
Core Tip: Accepted curative modalities for early hepatocellular carcinoma (HCC) include resection, liver transplant, and loco-regional therapies. In this manuscript, we review the curative-intent loco-regional therapies including recent evidence from the LEGACY study and DOSISPHERE trial demonstrating a curative role for transarterial radio-embolization in early HCC.
