Hepatocellular Carcinoma - Challenges and Opportunities of a Multidisciplinary Approach [Working Title]

2021 ◽  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multidisciplinary Approach ◽  
Challenges And Opportunities ◽  
Approach Working

scholarly journals Optimal management of hepatocellular carcinoma: Challenges and opportunities

2010 ◽  
Vol 25 (8) ◽  
pp. 1336-1338 ◽  
Author(s):  
Chih-Lin Lin ◽  
Jia-Horng Kao
Keyword(s):  
Hepatocellular Carcinoma ◽  
Optimal Management ◽  
Challenges And Opportunities

Role of hepatologists in management of hepatocellular carcinoma in the new era of transplant oncology.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 501-501
Author(s):  
Divya Ashat ◽  
Mark Karwal ◽  
Shiliang Sun ◽  
Sandeep Laroia ◽  
Tomohiro Tanaka
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multidisciplinary Approach ◽  
Complete Response ◽  
Meld Score ◽  
Locoregional Therapy ◽  
Direct Role ◽  
New Era ◽  
Tumor Boards ◽  
Median Diameter

501 Background: There have been global efforts to manage hepatobiliary malignancies such as hepatocellular carcinoma (HCC) in a multidisciplinary setting under the concept of transplant oncology. We published preliminary data of hepatology-directed treatment of HCC (Ann Hepatol 2019). However, the actual role of hepatologists in this setting is not well defined. Methods: We evaluated 107 patients with newly diagnosed HCC, undergoing locoregional therapy (LRT) as a first therapy (microwave ablation, TACE, TARE or SBRT) in our institution between 1/2017 to 2/2019 and being followed until 8/2019. Patients were divided into three groups based on referral pathways: outside referral directly to oncologists (O-group, n=24), internal referral from hepatologists to oncologists (H/O-group, n=62) and hepatologist directed HCC treatment (H-group, n=21). The hepatologist performed all microwave ablations in H-group; rest of the LRTs were performed by either interventional radiology or radiation oncology. Results: The baseline gender, etiology of liver disease, MELD score, Child-Pugh score, BCLC stage, CLIP score, AFP and proportion of patients within Milan criteria were similar between 3 groups ( p=n.s.). However, O-group included older patients (median 70 vs 63/62 y.o., p<0.01), and had larger HCC size (median diameter 41 vs 26/28mm, p<0.01). In H-group, there were more cases discussed in multidisciplinary tumor boards (77% vs 46%, p=0.012) and referrals for liver transplantation (71% versus 50%, p=0.046). Time between the diagnosis and the first procedure was shorter in H-group than others (median 53 vs 69 days, p=0.048). The rate of complete response/partial response per mRECIST criteria was highest in H-group (91 vs 66%, p=0.024). The 2-year cumulative survival was comparable among three groups (70, 74 and 76% in O-group, H/O-group and H-group, respectively, p=0.4). Conclusions: Hepatologists are often the first point of contact and can play a key (and even more direct) role in subsequent management of HCC. To further accomplish the concept of multidisciplinary approach and transplant oncology, primary/secondary care institutions might be a potential target for intervention for outreach.

scholarly journals Multidisciplinary treatment of advanced hepatocellular carcinoma with severe arterioportal shunt: a case report

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110248
Author(s):  
Yao-chang Luo ◽  
Hai-lin Lu ◽  
Wen-ling Song ◽  
Fei-fei Xuan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Multidisciplinary Treatment ◽  
Advanced Hepatocellular Carcinoma ◽  
Term Survival ◽  
Arterioportal Shunt ◽  
Advanced Stages ◽  
Interventional Radiology Procedures

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer mortality globally. In addition, most patients present in advanced stages with limited curative treatment options. Therefore, multidisciplinary treatment is often warranted. Here, we report a patient with HCC and severe arterioportal shunt (APS) who was treated with a multidisciplinary approach comprising interventional radiology procedures, apatinib and camrelizumab. After treatment, the intrahepatic mass was stable, and a notable decrease in the number and size of lung lesions was observed. The patient achieved a long-term survival of more than 2 years. These data suggest that multidisciplinary treatments may be effective in the treatment of advanced HCC with severe APS.

scholarly journals Role of Multidisciplinary Care in the Management of Hepatocellular Carcinoma

2021 ◽  
Author(s):  
Kia Byrd ◽  
Saleh Alqahtani ◽  
Adam C. Yopp ◽  
Amit G. Singal
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Multidisciplinary Care ◽  
Multimodal Approach ◽  
Poor Survival ◽  
The Past ◽  
Different Types ◽  
Potential Structure

AbstractDespite advances in treatment options for hepatocellular carcinoma (HCC), 5-year survival for HCC remains below 20%. This poor survival is multifactorial but is partly related to underuse of curative treatment in clinical practice. In light of growing treatment options, delivered by different types of providers, optimal management requires input from multiple specialties. A multidisciplinary approach has been evolving over the past couple of decades, bringing different specialists together to develop a therapeutic plan to treat and manage HCC, which significantly increases timely guideline-concordant treatment and improves overall survival. The present review attempts to highlight the need for such a multimodal approach by providing insights on its potential structure and impact on the various aspects of HCC management.

scholarly journals The role of a multidisciplinary approach in the treatment of hepatocellular carcinoma

2020 ◽  
Vol 21 (4) ◽  
pp. 10-14
Author(s):  
Oleg I. Kit ◽  
Liubov Iu. Vladimirova ◽  
Anna E. Storozhakova ◽  
Tatiana A. Snezhko ◽  
Elena A. Kalabanova ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Practice ◽  
Targeted Therapy ◽  
Surgical Treatment ◽  
Viral Hepatitis ◽  
Multidisciplinary Approach ◽  
Local Treatment ◽  
Treatment Methods ◽  
Viral Hepatitis C ◽  
Advanced Stages

Aim. Evaluation of treatment options and efficacy in patients with hepatocellular carcinoma based on data from the FSBI Rostov Cancer Research Institute using a multidisciplinary approach to the problem. Materials and methods. 124 cases of hepatocellular carcinoma were analyzed. In 79.8% of patients (average age of 61.4 years) the disease was diagnosed at advanced stages (IIIIV). Antibodies to viral hepatitis B were detected in 18 (14.5%) patients, and antibodies to viral hepatitis C in 35 (28.2%) patients. Liver cirrhosis occurred in 38 (30.6%) cases, and ChildPugh class A in 20 (16.1%) cases. In the FSBI RCRI, a multidisciplinary approach has been introduced into clinical practice; decision on treatment tactics is made with a close cooperation of several specialists. The use of special treatment methods was available in 67 (54%) patients. 32 patients with Barcelona Clinic Liver Cancer (BCLC) stage A (early) or stage B (intermediate), had surgical treatment or hepatic arterial chemoembolization (HACE) with lipiodol or microspheres using various cytostatics (18 and 14 patients, respectively). 35 patients with advanced stage C were given a systemic therapy with various cytostatics (gemcitabine, oxaliplatin, doxorubicin) or targeted therapy with sorafenib. The treatment efficacy was assessed according to mRECIST. Results. The best median overall survival (OS) up to 21 months was in the group of patients (n=18) who underwent volume resection surgery. In this group, sorafenib was prescribed to 2 patients after surgery. When performing HACE, the median OS was 14.2 months. In 6 patients, HACE was performed 2 or more times. Among the 14 patients who had HACE, sorafenib was prescribed in 8 cases, and the median OS in this group was 16.3 months. 20 patients were given targeted therapy with sorafenib. Following 3 months of taking the drug, 16 patients achieved stabilization of the disease according to the mRECIST, in 1 patient a partial response, in 3 patients disease progression. Median OS was 9.1 months; progression-free survival among patients treated with sorafenib was 5.4 months. Conclusions. The use of a multidisciplinary approach in clinical practice makes it possible to choose the optimal treatment option for hepatocellular carcinoma and contributes to the improvement in OS. The combination of local treatment methods (surgical treatment, HACE) with effective drug therapy is the most optimal approach to treating patients with advanced stages of hepatocellular carcinoma.

scholarly journals Immunotherapy for Hepatocellular Carcinoma: Current Status and Future Prospects

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhuoyan Liu ◽  
Xuan Liu ◽  
Jiaxin Liang ◽  
Yixin Liu ◽  
Xiaorui Hou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Checkpoint Inhibitors ◽  
Primary Liver Cancer ◽  
Rapid Development ◽  
Adoptive Cell Therapy ◽  
Research Field ◽  
Research Progress ◽  
Current Status ◽  
Challenges And Opportunities ◽  
Therapeutic Cancer Vaccines

Hepatocellular carcinoma (HCC) is the most prevalent primary liver cancer with poor prognosis. Surgery, chemotherapy, and radiofrequency ablation are three conventional therapeutic options that will help only a limited percentage of HCC patients. Cancer immunotherapy has achieved dramatic advances in recent years and provides new opportunities to treat HCC. However, HCC has various etiologies and can evade the immune system through multiple mechanisms. With the rapid development of genetic engineering and synthetic biology, a variety of novel immunotherapies have been employed to treat advanced HCC, including immune checkpoint inhibitors, adoptive cell therapy, engineered cytokines, and therapeutic cancer vaccines. In this review, we summarize the current landscape and research progress of different immunotherapy strategies in the treatment of HCC. The challenges and opportunities of this research field are also discussed.

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