Kumari Ratna, Sahu Manoj Kumar, Tripathy Anindita, Uthansingh Kanishka, Behera Manas
KIIT School of Biotechnology, KIIT University, Bhubaneswar, India.
Department of Gastroenterology & Hepatobiliary Sciences, IMS & SUM Hospital, Bhubaneswar, India.
Hepat Oncol. 2018 Sep 28;5(2):HEP08. doi: 10.2217/hep-2018-0002. eCollection 2018 Apr.
Hepatocellular carcinoma (HCC) is one of the major causes of cancer-related mortality and is particularly refractory to the available chemotherapeutic drugs. Among various etiologies of HCC, viral etiology is the most common, and, along with alcoholic liver disease and nonalcoholic steatohepatitis, accounts for almost 90% of all HCC cases. HCC is a heterogeneous tumor associated with multiple signaling pathway alterations and its complex patho-physiology has made the treatment decision challenging. The potential curative treatment options are effective only in small group of patients, while palliative treatments are associated with improved survival and quality of life for intermediate/advanced stage HCC patients. This review article focuses on the currently available treatment strategies and hurdles encountered for HCC therapy. The curative treatment options discussed are surgical resection, liver transplantation, and local ablative therapies which are effective for early stage HCC patients. The palliative treatment options discussed are embolizing therapies, systemic therapies, and molecular targeted therapies. Besides, the review also focuses on hurdles to be conquered for successful treatment of HCC and specifies the future prospects for HCC treatment. It also discusses the multi-modal approach for HCC management which maximizes the chances of better clinical outcome after treatment and identifies that selection of a particular treatment regimen based on patients' disease stage, patients' ages, and other underlying factors will certainly lead to a better prognosis.
肝细胞癌（HCC）是癌症相关死亡的主要原因之一，并且对现有的化疗药物特别难治。在HCC的各种病因中，病毒病因最为常见，与酒精性肝病和非酒精性脂肪性肝炎一起，几乎占所有HCC病例的90%。HCC是一种异质性肿瘤，与多种信号通路改变有关，其复杂的病理生理学使得治疗决策具有挑战性。潜在的根治性治疗方案仅对一小部分患者有效，而姑息性治疗则与改善中晚期HCC患者的生存率和生活质量相关。这篇综述文章重点关注HCC治疗目前可用的治疗策略和遇到的障碍。讨论的根治性治疗方案包括手术切除、肝移植和局部消融治疗，这些对早期HCC患者有效。讨论的姑息性治疗方案包括栓塞治疗、全身治疗和分子靶向治疗。此外，该综述还关注成功治疗HCC需要克服的障碍，并明确了HCC治疗的未来前景。它还讨论了HCC管理的多模式方法，这种方法可最大限度地提高治疗后获得更好临床结果的机会，并指出根据患者的疾病阶段、年龄和其他潜在因素选择特定的治疗方案肯定会带来更好的预后。
