Operative Therapie des hepatozellulären Karzinoms View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-07-23

AUTHORS

S.A. Farkas, H.J. Schlitt

ABSTRACT

BackgroundCurative surgical strategies for hepatocellular carcinoma are liver resection and transplantation.MethodsThis overview is based on a selective literature search on therapeutic strategies for hepatocellular carcinoma. The new German S3 guidelines are outlined in detail but guidelines from other societies were also taken into consideration.ResultsThe question of resectability is of utmost importance and should not only be evaluated in an interdisciplinary tumor board but also in an experienced liver center. Primary resectable hepatocellular carcinoma in patients without portal hypertension should be resected. Most patients without cirrhosis qualify for resection. In patients with Child grade A cirrhosis but without severe portal hypertension and a stable health status, a liver resection should be considered. At resection intraoperative ultrasound is standard. Intrahepatic tumor recurrences also can be re-resected or thermally ablated. New techniques for extended liver resections or minimally invasive liver resections are commonly used and have to be studied further.ConclusionIn addition to liver resection, liver transplantation now represents a standard therapy for hepatocellular carcinoma in cirrhosis. Observing the Milan selection criteria 5-year survival rates of 70–90 % can be achieved; however, increasing organ shortage leads to longer waiting times and thus higher risk of tumor progression. Therefore, patients on the waiting list should have follow-up imaging and bridging with surgical resection, radiofrequency ablation (RFA) or transarterial chemoembolization (TACE) by interventional radiology. Living donor liver transplantation should be considered in all these patients with expected longer waiting times. More... »

PAGES

673-678

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00117-014-2653-3

DOI

http://dx.doi.org/10.1007/s00117-014-2653-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1032984588

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25047523


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216 rdf:type schema:Organization
 




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