Fernandes Eduardo De Souza Martins, Rodrigues Pablo Duarte, Álvares-da-Silva Mário Reis, Scaffaro Leandro Armani, Farenzena Maurício, Teixeira Uirá Fernandes, Waechter Fábio Luiz
Department of Surgery, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
Digestive Surgery Division, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
Transl Gastroenterol Hepatol. 2019 Feb 18;4:12. doi: 10.21037/tgh.2019.01.02. eCollection 2019.
Liver cancer ranks fifth in incidence and fourth in overall cancer-related mortality, with approximately 854,000 new cases and 810,000 deaths per year worldwide. Hepatocellular carcinoma (HCC) accounts for 90% of these cases, and, over time, both the incidence and mortality of this cancer have been rising in many regions. Several staging systems are used to assess the extent of primary tumor, presence of metastasis, and underlying liver disease, and thereby aid in the definition of treatment strategies and prognosis for these patients. The consequence of this heterogeneity in HCC staging is that no consensual definition of advanced disease exists, and there is still ongoing debate on the optimal treatment for these patients. Patients with advanced tumors can be candidates for multiple therapies, ranging from potentially curative options such as transplantation and resection-to locoregional and systemic treatments; these should be evaluated on an individual basis by a multidisciplinary team. This paper provides an overview of treatment options for advanced stage HCC, based on a review of the latest relevant literature and the personal experience of the authors.
肝癌的发病率位居第五，在所有癌症相关死亡率中位列第四，全球每年约有85.4万新发病例和81万例死亡。肝细胞癌（HCC）占这些病例的90%，并且随着时间的推移，这种癌症在许多地区的发病率和死亡率都在上升。有几种分期系统用于评估原发肿瘤的范围、转移情况以及潜在的肝脏疾病，从而有助于确定这些患者的治疗策略和预后。HCC分期存在这种异质性的后果是，对于晚期疾病没有达成共识的定义，并且对于这些患者的最佳治疗仍存在持续的争论。晚期肿瘤患者可以选择多种治疗方法，从潜在的治愈性选择如移植和切除到局部区域和全身治疗；这些应通过多学科团队根据个体情况进行评估。本文基于对最新相关文献的综述和作者的个人经验，概述了晚期HCC的治疗选择。
