Zane Kylie E, Nagib Paul B, Jalil Sajid, Mumtaz Khalid, Makary Mina S
College of Medicine, The Ohio State University, Columbus, OH 43210, United States.
Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
World J Hepatol. 2022 May 27;14(5):885-895. doi: 10.4254/wjh.v14.i5.885.
Hepatocellular carcinoma (HCC) is the most common cause of liver malignancy and the fourth leading cause of cancer deaths universally. Cure can be achieved for early stage HCC, which is defined as 3 or fewer lesions less than or equal to 3 cm in the setting of Child-Pugh A or B and an ECOG of 0. Patients outside of these criteria who can be down-staged with loco-regional therapies to resection or liver transplantation (LT) also achieve curative outcomes. Traditionally, surgical resection, LT, and ablation are considered curative therapies for early HCC. However, results from recently conducted LEGACY study and DOSISPHERE trial demonstrate that transarterial radio-embolization has curative outcomes for early HCC, leading to its recent incorporation into the Barcelona clinic liver criteria guidelines for early HCC. This review is based on current evidence for curative-intent loco-regional therapies including radioembolization for early-stage HCC.
肝细胞癌（HCC）是肝脏恶性肿瘤最常见的病因，也是全球癌症死亡的第四大主要原因。早期HCC可实现治愈，其定义为在Child-Pugh A或B级、东部肿瘤协作组（ECOG）评分为0的情况下，有3个或更少直径小于或等于3 cm的病灶。不符合这些标准但可通过局部区域治疗降期至可进行切除或肝移植（LT）的患者也能获得治愈性结果。传统上，手术切除、LT和消融被认为是早期HCC的治愈性疗法。然而，最近进行的LEGACY研究和DOSISPHERE试验结果表明，经动脉放射性栓塞对早期HCC有治愈性结果，这导致其最近被纳入巴塞罗那临床肝癌标准指南中关于早期HCC的内容。本综述基于目前关于包括早期HCC放射性栓塞在内的治愈性局部区域治疗的证据。
