[Nonsurgical management of hepatocellular carcinoma].
Most of patients with hepatocellular carcinoma (HCC) cannot benefit from surgical therapies. Among nonsurgical options, only radiofrequency can challenge surgery for small size tumours. Conformal radiotherapy is likely highly efficient on solitary tumours, but controlled studies are warranted to conclude. Other options are purely palliative. Transarterial hepatic chemoembolization is the goal-standard for multifocal hepatocellular carcinoma and sorafenib for hepatocellular carcinoma with portal vein invasion, leading to modest but significant benefit on survival rates. Yttrium-90 radioembolization is under evaluation through controlled studies, and could be of major interest for multifocal hepatocellular carcinoma with or without portal venous invasion.
Merle
P
P
Service d'Hépato-Gastroentérologie, Hôpital de l'Hôtel-Dieu, 1, Place de l'Hôpital, 69002 Lyon, France. philippe.merle@inserm.fr
Mornex
F
F
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D001557:Benzenesulfonates / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D016503:Drug Delivery Systems; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D009361:Neoplasm Invasiveness; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011169:Portal Vein; D011725:Pyridines / Q000627:therapeutic use; D020266:Radiotherapy, Conformal; D000077157:Sorafenib; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D020533:Angiogenesis Inhibitors; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D015021:Yttrium Radioisotopes; D009536:Niacinamide; D000077157:Sorafenib