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Minimally invasive local therapies for liver cancer.

Li D, Kang J, Golas BJ, Yeung VW, Madoff DC - Cancer Biol Med (2014)

Bottom Line: For patients with low volume disease, these therapies have now been established into consensus practice guidelines.This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT).In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed.

View Article: PubMed Central - PubMed

Affiliation: 1 Department of Radiology, Division of Interventional Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY 10065, USA ; 2 Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA ; 3 Flushing Radiation Oncology Services, Flushing, New York, NY 11354, USA ; 4 Department of Surgery, Division of Surgical Oncology, New York-Presbyterian Hospital/Weill Cornell Medical Center New York, New York, NY 10065, USA.

ABSTRACT
Primary and metastatic liver tumors are an increasing global health problem, with hepatocellular carcinoma (HCC) now being the third leading cause of cancer-related mortality worldwide. Systemic treatment options for HCC remain limited, with Sorafenib as the only prospectively validated agent shown to increase overall survival. Surgical resection and/or transplantation, locally ablative therapies and regional or locoregional therapies have filled the gap in liver tumor treatments, providing improved survival outcomes for both primary and metastatic tumors. Minimally invasive local therapies have an increasing role in the treatment of both primary and metastatic liver tumors. For patients with low volume disease, these therapies have now been established into consensus practice guidelines. This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT). In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed.

No MeSH data available.


Related in: MedlinePlus

Barcelona clinic liver cancer treatment strategy. (Reprinted with permission from Forner et al.2).
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f1: Barcelona clinic liver cancer treatment strategy. (Reprinted with permission from Forner et al.2).

Mentions: The management of both primary tumors and metastases confined to the liver is best served with a multidisciplinary approach as adopted by multiple consensus guidelines, including the National Comprehensive Cancer Network (NCCN) and the European Association for the Study of the Liver (EASL)11,12,19. For HCC, multiple clinical staging systems have been developed in order to stratify patients towards appropriate treatments dependent on prognosis20. These staging systems typically stratify patients according to three generalized parameters: clinical performance status, extent of tumor, and liver function. One of the most widely adopted prognostic staging systems is the Barcelona Clinic Liver Cancer (BCLC) treatment strategy (Figure 1)21,22.


Minimally invasive local therapies for liver cancer.

Li D, Kang J, Golas BJ, Yeung VW, Madoff DC - Cancer Biol Med (2014)

Barcelona clinic liver cancer treatment strategy. (Reprinted with permission from Forner et al.2).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296086&req=5

f1: Barcelona clinic liver cancer treatment strategy. (Reprinted with permission from Forner et al.2).
Mentions: The management of both primary tumors and metastases confined to the liver is best served with a multidisciplinary approach as adopted by multiple consensus guidelines, including the National Comprehensive Cancer Network (NCCN) and the European Association for the Study of the Liver (EASL)11,12,19. For HCC, multiple clinical staging systems have been developed in order to stratify patients towards appropriate treatments dependent on prognosis20. These staging systems typically stratify patients according to three generalized parameters: clinical performance status, extent of tumor, and liver function. One of the most widely adopted prognostic staging systems is the Barcelona Clinic Liver Cancer (BCLC) treatment strategy (Figure 1)21,22.

Bottom Line: For patients with low volume disease, these therapies have now been established into consensus practice guidelines.This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT).In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed.

View Article: PubMed Central - PubMed

Affiliation: 1 Department of Radiology, Division of Interventional Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY 10065, USA ; 2 Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA ; 3 Flushing Radiation Oncology Services, Flushing, New York, NY 11354, USA ; 4 Department of Surgery, Division of Surgical Oncology, New York-Presbyterian Hospital/Weill Cornell Medical Center New York, New York, NY 10065, USA.

ABSTRACT
Primary and metastatic liver tumors are an increasing global health problem, with hepatocellular carcinoma (HCC) now being the third leading cause of cancer-related mortality worldwide. Systemic treatment options for HCC remain limited, with Sorafenib as the only prospectively validated agent shown to increase overall survival. Surgical resection and/or transplantation, locally ablative therapies and regional or locoregional therapies have filled the gap in liver tumor treatments, providing improved survival outcomes for both primary and metastatic tumors. Minimally invasive local therapies have an increasing role in the treatment of both primary and metastatic liver tumors. For patients with low volume disease, these therapies have now been established into consensus practice guidelines. This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT). In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed.

No MeSH data available.


Related in: MedlinePlus