Kolligs F T, Hoffmann R-T, op den Winkel M, Bruns C J, Herrmann K, Jakobs T F, Lamerz R, Trumm C, Zech C J, Wilkowski R, Graeb C
Medizinische Klinik und Poliklinik II, Klinikum der Universität München, Campus Grosshadern, München, Germany.
Z Gastroenterol. 2010 Feb;48(2):274-88. doi: 10.1055/s-0028-1109901. Epub 2010 Jan 29.
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death in the world. The majority of HCCs develops on the basis of a chronic liver disease. This often complicates diagnosis and therapy. Non-invasive diagnostic criteria are based on dynamic imaging techniques and the serum level of AFP (alpha-fetoprotein). When evaluating HCC patients for therapy, besides tumor burden and localisation, the therapeutic evaluation must also consider the general condition of the patient and his/her liver function. For this purpose, the BCLC algorithm of the Barcelona Clinic for Liver Disease has proven helpful. Only one-third of the patients can be cured by resection, transplantation or local tumour ablation. In locally advanced cases transarterial procedures including transarterial chemoembolisation and radioembolisation are applied. HCC is a chemo-resistant tumour and chemotherapy is not accepted as standard of care in HCC. Sorafenib is the first systemic treatment with proven efficacy approved for the treatment of advanced and metastatic HCC. Interdisciplinary management of HCC patients is essential in order to provide every patient with the optimal therapy at his specific stage of disease.
肝细胞癌（HCC）是全球癌症相关死亡的主要原因之一。大多数肝细胞癌是在慢性肝病的基础上发展而来的。这常常使诊断和治疗变得复杂。非侵入性诊断标准基于动态成像技术和甲胎蛋白（AFP）的血清水平。在评估肝细胞癌患者的治疗方案时，除了肿瘤负荷和定位外，治疗评估还必须考虑患者的一般状况及其肝功能。为此，巴塞罗那肝病诊所的BCLC算法已被证明是有帮助的。只有三分之一的患者可以通过手术切除、移植或局部肿瘤消融治愈。在局部晚期病例中，采用包括经动脉化疗栓塞和放射性栓塞在内的经动脉治疗方法。肝细胞癌是一种化疗耐药性肿瘤，化疗不作为肝细胞癌的标准治疗方法。索拉非尼是首个被批准用于治疗晚期和转移性肝细胞癌且疗效得到证实的全身治疗药物。肝细胞癌患者的多学科管理至关重要，以便为每位处于特定疾病阶段的患者提供最佳治疗。
