In:
Asia-Pacific Journal of Clinical Oncology, Wiley, Vol. 9, No. 4 ( 2013-12), p. 357-364
Kurzfassung:
Advanced hepatocellular carcinoma ( HCC ) with vascular invasion or extrahepatic metastasis has been considered a contraindication for transarterial chemoembolization ( TACE ) treatment according to B arcelona C linic L iver C ancer ( BCLC ) staging classification. However, real clinical practice varies among different countries. In recent years another opinion has been developing that considers that TACE can be safely performed in advanced HCC patients. Methods All studies on the efficacy of TACE for patients with advanced HCC were identified via the P ub M ed database. The primary items were TACE and HCC . Results We identified 15 studies in the treatment of TACE in advanced HCC patients. Most adverse events reported were treated successfully and in these studies there were no procedure‐related deaths within 4 weeks of the TACE treatment. Four controlled studies reported that TACE increased survival rate and prolonged overall survival compared with conservative management. The most frequent prognostic factors were liver function and the degree of portal vein tumor thrombosis. Conclusion TACE can be safely performed in advanced HCC patients with vascular invasion or extrahepatic spread and may improve their overall survival. Patients with portal vein branch invasion and well‐preserved liver function seemed to derive optimal benefit from treatment with TACE . Further studies are needed to provide strong evidence of the efficacy of TACE for advanced HCC patients to update the BCLC staging system.
Materialart:
Online-Ressource
ISSN:
1743-7555
,
1743-7563
DOI:
10.1111/ajco.2013.9.issue-4
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2013
ZDB Id:
2187409-8
