title: Towards the optimization of management of hepatocellular carcinoma.
abstract: Hepatocellular carcinoma (HCC) is the fifth most common neoplasm in the world, closely correlated with viral hepatitis and liver cirrhosis. The vast majority of HCC patients present at a late stage and are unsuitable for surgery due to limited liver functional reserve. Tumors can involve major vessels or hilar structures, necessitating major liver resection and/or rendering liver resection unfeasible. A series of new technologies have been developed to optimise HCC management. Stem cell therapy improves impaired liver functional reserve prior to liver resection. Intravascular radiofrequency ablation recanalises the portal vein invaded by tumour thrombus and endobiliary radiofrequency ablation restores and extends biliary patency of the bile duct invaded by malignancy. Laparoscopic radiofrequency assisted liver resection minimizes blood loss and avoids liver warm ischemia, while increasing parenchymal sparing. These benefits combined maximize the safety of liver resection.
authors.affiliation: Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, W12 0NN, UK.
authors.forename: Xi
authors.initials: X
authors.lastname: Feng
authors.forename: Madhava
authors.initials: M
authors.lastname: Pai
authors.forename: Malkhaz
authors.initials: M
authors.lastname: Mizandari
authors.forename: Tinatin
authors.initials: T
authors.lastname: Chikovani
authors.forename: Duncan
authors.initials: D
authors.lastname: Spalding
authors.forename: Long
authors.initials: L
authors.lastname: Jiao
authors.forename: Nagy
authors.initials: N
authors.lastname: Habib
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery* / Q000628:therapy; D017115:Catheter Ablation / Q000379:methods / Q000639:trends; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods / Q000639:trends; D006498:Hepatectomy / Q000379:methods / Q000639:trends*; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000639:trends; D008099:Liver / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery* / Q000628:therapy; D033581:Stem Cell Transplantation / Q000379:methods / Q000639:trends