【医脉通指南频道】2010+AHPBA／SSO／SSAT专家共识声明：结合形态学治疗肝细胞癌的非手术疗法.pdfVIP

DOI:10.1111/j.1477-2574.2010.00183.x HPB ORIGINAL ARTICLE Nonoperative therapies for combined modality treatment of hepatocellular cancer: expert consensus statement Roderich E. Schwarz1, Ghassan K. Abou-Alfa2, Jeffrey F. Geschwind3, Sunil Krishnan4, Riad Salem5 Alan P. Venook6 1Department of Surgery, UT Southwestern Medical Center, Dallas, TX, 2Department of Medical Oncology, Memorial – Sloan Kettering Cancer Center, New York, NY, 3Department of Interventional Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, 4Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, 5Department of Interventional Oncology, Department of Radiology, Northwestern Memorial Hospital, Chicago, IL, 6Division of Medical Oncology, University of California, San Francisco, CA, USA. Abstracthpb_183 313..320 Although surgical resection and liver transplantation are the only treatment modalities that enable prolonged survival in patients with hepatocellular carcinoma (HCC), the majority of HCC patients presents with advanced disease and do not undergo resective or ablative therapy. Transarterial chemoembolization (TACE) is indicated in intermediate/advanced stage unresectable HCC even in the setting of portal vein involvement (excluding main portal vein). Sorafenib has been shown to improve survival of patients with advanced HCC in two controlled randomized trials. Yttrium 90 is a safe microembolization treatment that can be used as an alternative to TACE in patients with advanced liver only disease or in case of portal vein thrombosis. External beam radiation can be helpful to provide local control in selected unresectable HCC. These different treatment modalities may be combined in the treatment strategy of HCC and also used as a bridge to resection or liver transplantation. Patients should undergo formal multidisciplinary evaluation p