Hepatocellular Carcinoma: Review of Current Treatment with a Focus on Transarterial Chemoembolization and Radiofrequency AblationReport as inadecuate




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Hepatocellular carcinoma HCC is one of the most deadly tumors and itsincidence has been rising worldwide. In its various stages, several modalitiesof treatment and therapies have been developed. Appropriate HCC treatment needsto consider the tumor stage, underlying liver disease and patient’s performancelevels. Liver transplantation is an effective treatment but unreliable due toscarcity of donors, whereas surgical resection possesses the potential toachieve long-term survival. However, most tumors are not resectable due totheir size, location, number and the function of the liver being compromised.Thus, resection is the first choice treatment for resectable tumors only. Thisprompts the rise of transarterial chemoembolization TACE for unresectableHCC. Progressively, radiofrequency ablation RFA arose though it exhibits highpostoperative recurrence and cancer mortality. Notably, identifying thebest-suited treatment is critical in enabling maximum long-term survival.Though HCC is an identified chemoresistant tumor, chemotherapies have beendeveloped for advanced HCC. Among them, sorafenib, blocks tumor cellproliferation thus improving patient survival, even though costly. Incomparison to RFA, TACE has been identified to have more complications andsymptoms. However, it demonstrates improved survival benefits and quality ofpatient care more than symptomatic supportive care. Furthermore, forunresectable HCC, TACE can replace the costly and modestly effective sorafenibtreatment; whereas RFA is potentially curative in treating HCC and analternative to liver transplantation or surgical resection in the early HCCstages. It treats primary and secondary liver tumor in the very early stageHCC. Its reliance on image guidance is minimally invasive and enhances itsefficacy and safety, especially where surgery will not have been possible.However, skin burns, hemorrhage, hepatic abscess and pleural effusion arecomplications that accompany RFA prompting the need for additional treatment.

KEYWORDS

Hepatocellular Carcinoma, Tumor, Treatment, Transarterial Chemoembolization, Radiofrequency Ablation

Cite this paper

Chhaniwal, N. , Li, C. , Wang, J. , Qiang, G. , Qi, T. and Maher, H. 2015 Hepatocellular Carcinoma: Review of Current Treatment with a Focus on Transarterial Chemoembolization and Radiofrequency Ablation. Open Journal of Radiology, 5, 50-58. doi: 10.4236-ojrad.2015.51009.





Author: Nikhar Chhaniwal1*, Cheng Li1, Jiaxiang Wang1, Guosheng Qiang1, Tingyue Qi2, Hendi Maher3

Source: http://www.scirp.org/



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