1Robert H. Lurie Comprehensive Cancer Center of Northwestern University.
2Memorial Sloan Kettering Cancer Center.
J Natl Compr Canc Netw. 2021 May 1;19(5):541-565. doi: 10.6004/jnccn.2021.0022.
The NCCN Guidelines for Hepatobiliary Cancers focus on the screening, diagnosis, staging, treatment, and management of hepatocellular carcinoma (HCC), gallbladder cancer, and cancer of the bile ducts (intrahepatic and extrahepatic cholangiocarcinoma). Due to the multiple modalities that can be used to treat the disease and the complications that can arise from comorbid liver dysfunction, a multidisciplinary evaluation is essential for determining an optimal treatment strategy. A multidisciplinary team should include hepatologists, diagnostic radiologists, interventional radiologists, surgeons, medical oncologists, and pathologists with hepatobiliary cancer expertise. In addition to surgery, transplant, and intra-arterial therapies, there have been great advances in the systemic treatment of HCC. Until recently, sorafenib was the only systemic therapy option for patients with advanced HCC. In 2020, the combination of atezolizumab and bevacizumab became the first regimen to show superior survival to sorafenib, gaining it FDA approval as a new frontline standard regimen for unresectable or metastatic HCC. This article discusses the NCCN Guidelines recommendations for HCC.
NCCN 肝胆肿瘤临床实践指南侧重于肝细胞癌(HCC)、胆囊癌和胆管癌(肝内和肝外胆管癌)的筛查、诊断、分期、治疗和管理。由于可以使用多种方法治疗该疾病,并且并存的肝功能障碍可能会引起并发症,因此多学科评估对于确定最佳治疗策略至关重要。多学科团队应包括具有肝胆癌专业知识的肝内科医生、诊断放射科医生、介入放射科医生、外科医生、肿瘤内科医生和病理学家。除了手术、移植和动脉内治疗外,HCC 的系统治疗也取得了很大进展。直到最近,索拉非尼仍是晚期 HCC 患者的唯一系统治疗选择。2020 年,阿替利珠单抗联合贝伐珠单抗成为首个显示生存优势优于索拉非尼的方案,获得 FDA 批准作为不可切除或转移性 HCC 的新一线标准治疗方案。本文讨论了 NCCN 肝胆肿瘤临床实践指南中 HCC 的推荐内容。
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