NONRESECTIONAL THERAPIES FOR HEPATOCELLULAR-CARCINOMA

BACKGROUND: Surgical resection is generally accepted as the first choi ce of treatment for hepatocellular carcinoma (HCC). However, due to it s multifocal nature, association with chronic liver disease, and frequ ent postresectional recurrence, nonresectional therapies are important in the management of a significant proportion of patients with HCC. D ATA SOURCES: A literature review was performed on the current status o f different nonresectional treatment modalities commonly employed for HCC. They include direct ablation methods, systemic chemotherapy, tran scatheter arterial chemoembolization, external and targeting radiother apy, hormonal therapy, and immunotherapy. Multidisciplinary therapy re sulting in preoperative cytoreduction has also been reported with impr ovement of therapeutic results. CONCLUSION: Nonresectional therapies p lay an essential role in the treatment of inoperable HCC as they lead to satisfactory survival. Percutaneous ethanol injection and transcath eter arterial chemoembolization are the most frequently employed modal ities, and they result in a 3-year survival rate of 55% to 70% and abo ut 20%, respectively. Multidisciplinary therapy appears to be the curr ent trend of management and improved survival is achieved especially w hen unresectable tumors are converted to resectable ones. (C) 1997 by Excerpta Medica, Inc.