Medical Management Options for Hepatocellular Carcinoma

摘要: Hepatocellular carcinoma (HCC) is typically diagnosed late in the course of patients with chronic liver disease and cirrhosis. Hepatic reserve patient, as indicated by Barcelona Clinic or Child-Pugh staging system, can be helpful determining therapeutic options. Because rapidly evolving new treatment options varying availability approaches to individual attempts generating algorithmic for hepatocellular may not applicable all situations. General divided into surgical non-surgical approaches. Non-surgical directed (such transarterial chemoembolozation, percutaneous ethanol injection, radiofrequency ablation) sysytemic therapy. Systemic palliative therapy HCC has been used routinely a number reasons; First, due high rate expression drug resistance genes, including p-glycoprotein, glutathione-S-transferase, heat shock proteins, mutations p53, considered relatively chemotherapyrefractory tumor. Second, systemic chemotherapy difficult tolerated significant underlying hepatic dysfunction have less efficacy Third, clinical investigations advanced undertaken diverse patient populations (Asian versus North American/European) making interpretation results overall population. Recently there resurgence interest enthusiasm emergence data showing benefit from several targeted therapies.