Transarterial Chemoembolization in Hepatocellular Carcinoma, Albanian Experience.

I. Laçi, A. Spahiu
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引用次数: 0

Abstract

Liver cancer is the sixth most common cancer worldwide in terms of the number of cases (626,000 or 5.7% of new cancer cases) but due to the very poor prognosis, the number of deaths is nearly similar (598,000). The survival rate is 3% to 5% in cancer registries for the United States and developing countries. The modality of treatment in hepatocellular carcinoma (HCC) patients depends on the stage of the disease. The Barcelona Clinic Liver Cancer Classification (BCLC) is the favorite staging system. There are many patients who initially present with the intermediate-stage disease, and in this setting transarterial chemoembolization (TACE) is the treatment of choice. The purpose of this article is to highlight and discuss the role of chemoembolization in the treatment of hepatocellular carcinoma, including the results of recent large studies, and the concept of combined therapies, illustrating our case. The differences in individual factors that are not captured by the BCLC framework, such as the tumor growth pattern, degree of hypervascularity, and vascular supply, complicate the further evaluation of these patients. Because of these differences, not all patients benefit equally from TACE. Several tools have been devised to aid the decision-making process which have shown promising initial results but have failed external evaluation and have not been translated to the clinical aspects. Criteria for treatment decisions in daily clinical practice are needed in all stages of the disease. Conclusion: TACE is a safe method for prolonging patients' survival with unresectable HCC. The correct treatment of HCC is concentrated in cancer centers, and cooperation between multiple specialists is necessary.
经动脉化疗栓塞治疗肝细胞癌,阿尔巴尼亚经验。
就病例数而言,肝癌是世界上第六大常见癌症(62.6万例,占新发癌症病例的5.7%),但由于预后非常差,死亡人数几乎相似(59.8万例)。在美国和发展中国家的癌症登记处,存活率是3%到5%。肝细胞癌(HCC)患者的治疗方式取决于疾病的分期。巴塞罗那临床肝癌分类(BCLC)是最受欢迎的分期系统。有许多患者最初表现为中期疾病,在这种情况下,经动脉化疗栓塞(TACE)是治疗的选择。本文的目的是强调和讨论化疗栓塞在肝细胞癌治疗中的作用,包括最近大型研究的结果,以及联合治疗的概念,以说明我们的病例。BCLC框架未捕捉到的个体因素的差异,如肿瘤生长模式、血管扩张程度和血管供应,使这些患者的进一步评估复杂化。由于这些差异,并非所有患者都能从TACE中受益。已经设计了一些工具来帮助决策过程,这些工具已经显示出有希望的初步结果,但没有经过外部评估,也没有转化为临床方面。在疾病的所有阶段都需要日常临床实践中的治疗决策标准。结论:TACE是一种安全的延长不可切除HCC患者生存期的方法。肝癌的正确治疗集中在癌症中心,需要多名专家的合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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