Cortese Francesco, Anagnostopoulos Fotis, Bazzocchi Maria Vittoria, Caringi Silvio, Pisani Antonio Rosario, Renzulli Matteo, Paraskevopoulos Ioannis, Laera Letizia, Surgo Alessia, Spiliopoulos Stavros, Memeo Riccardo, Inchingolo Riccardo
Interventional Radiology Unit, "F Miulli" Regional General Hospital, Acquaviva delle Fonti 70021, Italy.
The Second Radiology Department, National and Kapodistrian University of Athens, Chaidari Athens 12461, Greece.
World J Hepatol. 2025 Aug 27;17(8):107873. doi: 10.4254/wjh.v17.i8.107873.
Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, necessitating innovative treatment strategies. Surgical resection and liver transplantation continue to be the gold standards for early-stage HCC; however, advances in imaging and minimally invasive techniques have improved patient selection and outcomes. Additionally, the emergence of targeted therapies and immunotherapy has transformed the treatment landscape for advanced HCC. This review highlights the efficacy of agents such as tyrosine kinase inhibitors, alongside emerging options like immune checkpoint inhibitors, which have shown promise in clinical trials. Furthermore, the role of locoregional therapies, including ablation in the setting of combined treatment, transarterial chemoembolization and transarterial radioembolization with flow catheters, cone-beam computed tomography and 4D navigation guidance, is examined in the context of bridging therapies for patients awaiting surgical intervention. The integration of multidisciplinary care approaches and personalized treatment plans is crucial for optimizing outcomes. Future directions for HCC treatment are discussed, including the potential of novel biomarkers in prognosis and treatment response. This comprehensive overview aims to equip clinicians with the latest insights and foster collaborative efforts to improve HCC patient management and survival rates.
肝细胞癌(HCC)仍然是全球癌症相关死亡的主要原因,因此需要创新的治疗策略。手术切除和肝移植仍然是早期HCC的金标准;然而,成像技术和微创技术的进步改善了患者的选择和治疗效果。此外,靶向治疗和免疫治疗的出现改变了晚期HCC的治疗格局。本综述强调了酪氨酸激酶抑制剂等药物的疗效,以及免疫检查点抑制剂等新兴选择在临床试验中显示出的前景。此外,还在等待手术干预的患者的桥接治疗背景下,研究了局部区域治疗的作用,包括联合治疗中的消融、使用血流导管的经动脉化疗栓塞和经动脉放射性栓塞、锥形束计算机断层扫描和四维导航引导。多学科护理方法和个性化治疗计划的整合对于优化治疗效果至关重要。讨论了HCC治疗的未来方向,包括新型生物标志物在预后和治疗反应方面的潜力。这一全面概述旨在为临床医生提供最新见解,并促进合作努力,以改善HCC患者的管理和生存率。