Glantzounis Georgios K, Karampa Anastasia, Peristeri Dimitra V, Pappas-Gogos George, Tepelenis Kostas, Tzimas Petros, Cyrochristos Dimitrios J
HPB Unit, Department of Surgery (Georgios K. Glantzounis, Anastasia Karampa, Dimitra V. Peristeri, George Pappas-Gogos, Kostas Tepelenis, Dimitrios J. Cyrochristos).
Department of Anesthesiology (Petros Tzimas), University Hospital of Ioannina and School of Medicine, University of Ioannina, Ioannina, Greece.
Ann Gastroenterol. 2021 Jul-Aug;34(4):453-465. doi: 10.20524/aog.2021.0632. Epub 2021 May 27.
The incidence of hepatocellular carcinoma (HCC) is increasing, despite effective antiviral treatment for hepatitis B (HBV) and C virus infection and the application of preventive measures such as vaccination at birth against HBV infection. This is mainly due to the increase in metabolic syndrome and its hepatic components, nonalcoholic fatty liver disease and steatohepatitis. Liver resection and transplantation are the main treatment options, offering long-term survival and potential cure. In this review, the recent advances in the surgical management of HCC are presented. More specifically, the role of liver resection in the intermediate and advanced stages, according to the Barcelona Clinic Liver Cancer classification, is analyzed. In addition, the roles of minimally invasive surgery and of living-related liver transplantation in the management of patients with HCC are discussed. Finally, recent data on the role of molecular markers in the early diagnosis and recurrence of HCC are presented. The management of HCC is complex, as there are several options for each stage of the disease. In order for, each patient to get the maximum benefit, an individualized approach is suggested, in specialized liver units, where cases are discussed in multidisciplinary tumor boards.
尽管对乙型肝炎（HBV）和丙型肝炎病毒感染有有效的抗病毒治疗方法，并且采取了诸如出生时接种乙肝疫苗等预防措施，但肝细胞癌（HCC）的发病率仍在上升。这主要归因于代谢综合征及其肝脏相关组成部分——非酒精性脂肪性肝病和脂肪性肝炎的增加。肝切除和肝移植是主要的治疗选择，可提供长期生存和潜在治愈的可能。在本综述中，介绍了肝细胞癌外科治疗的最新进展。更具体地说，根据巴塞罗那临床肝癌分类，分析了肝切除在中晚期的作用。此外，还讨论了微创手术和活体肝移植在肝细胞癌患者管理中的作用。最后，介绍了分子标志物在肝细胞癌早期诊断和复发中的作用的最新数据。肝细胞癌的管理很复杂，因为疾病的每个阶段都有多种选择。为了让每个患者获得最大益处，建议在专门的肝脏科室采用个体化方法，在多学科肿瘤委员会中讨论病例。
