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Semin intervent Radiol 2021; 38(04): 432-437
DOI: 10.1055/s-0041-1735528
Review Article

Contemporary Algorithm for the Management of Hepatocellular Carcinoma in 2021: The Northwestern Approach

Adam Swersky
1   Section of Interventional Radiology, Department of Radiology, Northwestern Feinberg School of Medicine, Chicago, Illinois
,
Laura Kulik
2   Division of Hepatology, Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, Illinois
,
Aparna Kalyan
3   Division of Medical Oncology, Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, Illinois
,
Karen Grace
1   Section of Interventional Radiology, Department of Radiology, Northwestern Feinberg School of Medicine, Chicago, Illinois
,
Juan Carlos Caicedo
4   Division of Transplantation, Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, Illinois
,
Robert J. Lewandowski
1   Section of Interventional Radiology, Department of Radiology, Northwestern Feinberg School of Medicine, Chicago, Illinois
,
Riad Salem
1   Section of Interventional Radiology, Department of Radiology, Northwestern Feinberg School of Medicine, Chicago, Illinois
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Abstract

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a major cause of cancer-related morbidity and mortality around the world. Frequently, concurrent liver dysfunction and variations in tumor burden make it difficult to design effective and standardized treatment pathways. Contemporary treatment guidelines designed for an era of personalized medicine should consider these features in a more clinically meaningful way to improve outcomes for patients across the HCC spectrum. Given the heterogeneity of HCC, we propose a detailed clinical algorithm for selecting optimal treatment using an evidence-based and practical approach, incorporating liver function, tumor burden, the extent of disease, and ultimate treatment intent, with the goal of individualizing clinical decision making.

Keywords

radioembolization - yttrium-90 - downstaging - transplantation - survival - interventional radiology


Publication History

Article published online:
07 October 2021

© 2021. Thieme. All rights reserved.

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