NDLI: Hepatocellular carcinoma: Surgical perspectives beyond the barcelona clinic liver cancer recommendations

Content Provider	PubMed Central
Author	Guglielmi, Alfredo Andrea, Ruzzenente Simone, Conci Valdegamberi, Alessandro Vitali, Marco Bertuzzo, Francesca Angelis, Michela De Mantovani, Guido Iacono, Calogero
Copyright Year	2014
Abstract	The barcelona clinic liver cancer (BCLC) staging system has been approved as guidance for hepatocellular carcinoma (HCC) treatment guidelines by the main Western clinical liver associations. According to the BCLC classification, only patients with a small single HCC nodule without signs of portal hypertension or hyperbilirubinemia should undergo liver resection. In contrast, patients with intermediate-advanced HCC should be scheduled for palliative therapies, even if the lesion is resectable. Recent studies report good short-term and long-term outcomes in patients with intermediate-advanced HCC treated by liver resection. Therefore, this classification has been criticised because it excludes many patients who could benefit from curative resection. The aim of this review was to evaluate the role of surgery beyond the BCLC recommendations. Safe liver resection can be performed in patients with portal hypertension and well-compensated liver function with a 5-year survival rate of 50%. Surgery also offers good long-term result in selected patients with multiple or large HCCs with a reported 5-year survival rate of over 50% and 40%, respectively. Although macrovascular invasion is associated with a poor prognosis, liver resection provides better long-term results than palliative therapies or best supportive care. Recently, researchers have identified several genes whose altered expression influences the prognosis of patients with HCC. These genes may be useful for classifying the biological behaviour of different tumours. A revision of the BCLC classification should be introduced to provide the best treatment strategy and to ensure the best prognosis in patients with HCC.
Related Links	http://dx.doi.org/10.3748/wjg.v20.i24.7525
Ending Page	7533
Page Count	9
Starting Page	7525
File Format	PDF
ISSN	10079327
e-ISSN	22192840
Journal	World Journal of Gastroenterology : WJG
Issue Number	24
Volume Number	20
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2014-01-01
Access Restriction	Open
Rights Holder	Baishideng Publishing Group Inc
Subject Keyword	Gastroenterology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Gastroenterology

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