Hepatocellular carcinoma: current management and recent advances.
Hepatocellular carcinoma: current management and recent advances.
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发表时间：
2008-06
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通讯作者：
W. Lau;E. Lai
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作者：
W. Lau;E. Lai
背景肝细胞癌（HCC）是世界范围内的主要健康问题。它是世界上第五大常见癌症，也是癌症相关死亡的第三大常见原因。如果没有特殊的治疗，预后很差。管理的目标是“癌症控制”-降低其发病率和死亡率，以及改善HCC患者及其家属的生活质量。本文就肝细胞癌的治疗现状及最新进展作一综述。资料来源：检索MEDLINE数据库，使用关键词“肝细胞癌”、“肝切除术”、“肝移植”和“局部消融治疗”确定相关文章。通过手动检索关键文章的参考文献，确定了其他论文和书籍章节。结果肝切除和肝移植仍然是最有可能治愈的选择。最近的证据表明，局部消融治疗可能会提供类似的生存结果与小肝癌患者，并保留肝功能。经动脉化疗栓塞术（TACE）是最有希望的姑息性治疗方法，但其他技术，如经动脉放射性栓塞术（TARE）和局部消融治疗，也显示出相当的结果。结论肝癌的早期诊断是改善患者预后的关键。在过去的二十年中，手术死亡率和手术结果的肝切除和肝移植肝癌已改善。综合治疗也取得了进展，可以增加晚期肝癌患者的生存机会，改善生活质量。
BACKGROUND Hepatocellular carcinoma (HCC) is a major health problem worldwide. It is the fifth most common cancer in the world, and the third most common cause of cancer-related death. Without specific treatment, the prognosis is very poor. The goal of management is "cancer control"--a reduction in its incidence and mortality as well as an improvement in the quality of life of patients with HCC and their families. This article aims to review the current management of HCC and its recent advances. DATA SOURCES A MEDLINE database search was performed to identify relevant article using the keywords "hepatocellular carcinoma", "hepatectomy", "liver transplantation", and "local ablative therapy". Additional papers and book chapters were identified by a manual search of the references from the key articles. RESULTS Liver resection and liver transplantation remain the options that give the best chance of a cure. Recent evidence suggests that local ablative therapy may offer comparable survival results in patients with small HCC, and preserved liver function. Transarterial chemoembolization (TACE) is the most promising palliative modality for unresectable HCC, but other techniques, such as transarterial radioembolization (TARE), and local ablative therapy, have also shown comparable results. CONCLUSIONS Early diagnosis of HCC remains a key goal in improving the prognosis of patients. During the last two decades, operative mortality and surgical outcome of liver resection and liver transplantation for HCC have improved. Progress also has been made in multi-modality therapy which can increase the chance of survival and improve the quality of life for patients with advanced HCC.