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Hepatocellular Carcinoma

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Surgical Oncology

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Abstract

Management of patients with hepatocellular carcinoma poses unique challenges due to the typical combination of malignant disease and organ dysfunction. For patients with early solitary HCC and normal liver function or well-compensated liver dysfunction (Child-Turcotte-Pugh Class A cirrhosis), resection remains the treatment of choice. For patients with HCC meeting Milan Criteria (a single lesion <5 cm or up to three lesions each <3 cm), liver transplantation should be offered; donor organ availability and long wait times in some regions, however, may limit this therapeutic strategy. For patients with early HCC not amenable to surgical management, radiofrequency ablation is typically indicated for solitary lesions up to 3 cm in size. Patients with multiple HCC lesions and without evidence of macrovascular invasion or extrahepatic disease are candidates for locoregional embolic therapy, typically with transarterial chemoembolization (TACE) or radioembolization. For patients with advanced HCC, sorafenib is currently the only approved therapeutic agent.

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Abbreviations

PST:

Performance status (ECOG classification)

CLT:

Cadaveric liver transplantation

LDLT:

Living donor liver transplantation

RF:

Radiofrequency ablation

PEI:

Percutaneous ethanol injection

TACE:

Transarterial chemoembolization

OS:

Overall survival

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Authors and Affiliations

  1. Division of Surgical Oncology, Winship Cancer Institute, Emory University, 1365C Clifton Rd. NE, 2nd Floor, Atlanta, 30322, GA, USA

    Malcolm H. Squires III M.D. & David A. Kooby M.D.

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  1. Malcolm H. Squires III M.D.
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  2. David A. Kooby M.D.
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Correspondence to David A. Kooby M.D. .

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Editors and Affiliations

  1. Department of Surgery, LSU Health Sciences Center-Shreveport, Shreveport, Louisiana, USA

    Quyen D. Chu

  2. Department of Surgery, Jersey Shore University Medical Center, Neptune, New Jersey, USA

    John F. Gibbs

  3. John C. McDonald Regional Transplant Center, Willis Knighton Health System, Shreveport, Louisiana, USA

    Gazi B. Zibari

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Squires, M.H., Kooby, D.A. (2015). Hepatocellular Carcinoma. In: Chu, Q., Gibbs, J., Zibari, G. (eds) Surgical Oncology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1423-4_15

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  • DOI: https://doi.org/10.1007/978-1-4939-1423-4_15

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