Journal
LANCET
Volume 391, Issue 10127, Pages 1301-1314Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(18)30010-2
Keywords
-
Categories
Funding
- Instituto de Salud Carlos III [PI13/01229, PI15/00145, PI14/00962]
- AECC [PI044031]
- Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement [2014 SGR 605]
- WCR (AICR) [16-0026]
- Spanish Health Ministry (Plan Estrategico Nacional contra la Hepatitis C)
- Instituto de Salud Carlos III
Ask authors/readers for more resources
Hepatocellular carcinoma appears frequently in patients with cirrhosis. Surveillance by biannual ultrasound is recommended for such patients because it allows diagnosis at an early stage, when effective therapies are feasible. The best candidates for resection are patients with a solitary tumour and preserved liver function. Liver transplantation benefits patients who are not good candidates for surgical resection, and the best candidates are those within Milan criteria (solitary tumour <= 5 cm or up to three nodules <= 3 cm). Image-guided ablation is the most frequently used therapeutic strategy, but its efficacy is limited by the size of the tumour and its localisation. Chemoembolisation has survival benefit in asymptomatic patients with multifocal disease without vascular invasion or extrahepatic spread. Finally, sorafenib, lenvatinib, which is non-inferior to sorafenib, and regorafenib increase survival and are the standard treatments in advanced hepatocellular carcinoma. This Seminar summarises the scientific evidence that supports the current recommendations for clinical practice, and discusses the areas in which more research is needed.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available