Department of Radiology, Mount Sinai Medical Center, New York, USA.
Semin Liver Dis. 2013 Aug;33(3):213-25. doi: 10.1055/s-0033-1351778. Epub 2013 Aug 13.
The management algorithm for patents with liver lesions, most often hepatocellular carcinoma (HCC) or colorectal cancer metastasis, are complex, ever-changing, and involve multiple treatment modalities including chemotherapy, external-beam radiation, surgery, and locoregional therapies (LRTs). This complexity necessitates a multidisciplinary approach including hepatologists, oncologists, hepatobiliary surgeons, radiation oncologists, and interventional radiologists to coordinate and deliver the complex care that these patients need in a timely manner. The interventional radiologist and hepatobiliary surgeon work closely together in both the pre- and postoperative setting. Preoperative roles include delivering LRTs to patients with HCC and interventions aimed at hepatic optimization prior to resection or transplantation. LRT in this setting is performed either to bridge the patient to transplant or to downstage the initially nontransplant candidate so appropriate transplant criteria are met. Postoperative roles include the management of biliary and vascular complications that may occur after resection or transplantation.
肝病变（最常见的是肝细胞癌[HCC]或结直肠癌转移）的专利管理算法很复杂，且不断变化，涉及多种治疗方式，包括化疗、外照射、手术和局部区域治疗（LRT）。这种复杂性需要多学科方法，包括肝病专家、肿瘤专家、肝胆外科医生、放射肿瘤学家和介入放射学家，以协调并及时为这些患者提供复杂的护理。介入放射学家和肝胆外科医生在术前和术后密切合作。术前角色包括对 HCC 患者进行 LRT 治疗，以及在切除或移植前进行旨在优化肝脏的干预措施。该治疗的目的是为移植患者搭桥，或使最初不符合移植条件的患者降期，以满足适当的移植标准。术后角色包括管理切除或移植后可能发生的胆道和血管并发症。
