https://scholars.lib.ntu.edu.tw/handle/123456789/461603
Title: | Surgery for intermediate and advanced hepatocellular carcinoma: A consensus report from the 5th Asia-pacific primary liver cancer expert meeting (apple 2014) | Authors: | MING-CHIH HO Hasegawa K. Chen X.-P. Nagano H. Lee Y.-J. Chau G.-Y. Zhou J. Wang C.-C. Choi Y.R. Poon R.T.-P. Kokudo N. |
Keywords: | Hepatocellular carcinoma; outcome; staging system; surgery | Issue Date: | 2016 | Publisher: | S. Karger AG | Journal Volume: | 5 | Journal Issue: | 4 | Start page/Pages: | 245-256 | Source: | Liver Cancer | Abstract: | Background: The Barcelona Clinic Liver Cancer (BCLC) staging and treatment strategy does not recommended surgery for treating BCLC stage B and C hepatocellular carcinoma (HCC). However, numerous Asia-Pacific institutes still perform surgery for this patient group. This consensus report from the 5th Asia-Pacific Primary Liver Cancer Expert Meeting aimed to share opinions and experiences pertaining to liver resection for intermediate and advanced HCCs and to provide evidence to issue recommendations for surgery in this patient group. Summary: Thirteen experts from five Asia-Pacific regions were invited to the meeting; 10 of them (Japan: 2, Taiwan: 3, South Korea: 2, Hong Kong: 1, and China: 2) voted for the final consensus. The discussion focused on evaluating the preoperative liver functional reserve and surgery for large tumors, multiple tumors, HCCs with vascular invasion, and HCCs with distant metastasis. The feasibility of future prospective randomized trials comparing surgery with transarterial chemoembolization for intermediate HCC and with sorafenib for advanced HCC was also discussed. The Child-Pugh score (9/10 experts) and indocyanine green retention rate at 15 min (8/10) were the most widely accepted methods for evaluating the preoperative liver functional reserve. All (10/10) experts agreed that portal hypertension, tumor size >5 cm, portal venous invasion, hepatic venous invasion, and extrahepatic metastasis are not absolute contraindications for the surgical resection of HCC. Furthermore, 9 of the 10 experts agreed that tumor resection may be performed for patients with >3 tumors. The limitations of surgery are associated with a poor liver functional reserve, incomplete tumor resection, and a high probability of recurrence. Key Messages: Surgery provides significant survival benefits for Asian-Pacific patients with intermediate and advanced HCCs, particularly when the liver functional reserve is favorable. However, prospective randomized controlled trials are difficult to conduct because of technical and ethical considerations. ? 2016 S. Karger AG, Basel. Copyright: All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85006756569&doi=10.1159%2f000449336&partnerID=40&md5=76ae2815ce81820f6efb9352ed67198c https://scholars.lib.ntu.edu.tw/handle/123456789/461603 |
ISSN: | 2235-1795 | DOI: | 10.1159/000449336 | SDG/Keyword: | alpha interferon; fluorouracil; indocyanine green; sorafenib; Article; cancer combination chemotherapy; cancer patient; cancer recurrence; cancer size; cancer surgery; chemoembolization; Child Pugh score; China; clinical evaluation; consensus; controlled study; distant metastasis; Hong Kong; human; Japan; liver cell carcinoma; liver function; liver resection; major clinical study; multimodality cancer therapy; multiple cancer; portal hypertension; preoperative period; priority journal; South Korea; Taiwan; tumor invasion |
Appears in Collections: | 醫學系 |
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