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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2020; 41(04): 484-487
DOI: 10.4103/ijmpo.ijmpo_256_19
Editorial Commentary

Interventional Radiological Management of Hepatocellular Carcinoma

Abhishek Bansal
Department of Radiology and Interventional Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
,
Arvind Chaturvedi
Department of Radiology and Interventional Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
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Hepatocellular carcinoma (HCC) is the sixth-most common cancer worldwide and the fourth-most common cause of death due to cancers.[1] Its incidence is steadily increasing, and the common etiological factors include hepatitis B and C, alcohol-induced chronic liver disease, and nonalcoholic fatty liver disease.[2],[3] Multiple staging systems have been proposed for classifying and guiding treatment decisions based on various factors which include tumor burden, background liver function, and performance status of the patients. The Barcelona Clinic Liver Cancer (BCLC) system [Figure 1] is the most widely accepted and followed worldwide.[4],[5] However, certain authors have suggested that BCLC is too conservative in treatment recommendations and thus have advocated the usage of the Hong Kong Liver Cancer system [Figure 2].[6]

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Figure 1 Barcelona clinic liver cancer staging system
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Figure 2 Hong Kong liver cancer classification

HCC recurrences are frequently seen in patients who have undergone curative treatments.[7] Moreover, many patients in our country are no longer surgical candidates at the time of presentation.[8] Hence, a multidisciplinary approach is required for the management of HCC. With the development and emergence of interventional radiological (IR) treatments, the management of HCC has changed dramatically.[9],[10] IR treatments are curative in patients with early-stage disease, while they play a major role in controlling disease, improving the quality of life, and improving survival in patients with advanced stages.[10],[11]

The following IR treatment options are available for the treatment of HCC:

  • Ablation techniques

    • Chemical

    • Thermal

    • Electrical.

  • Transarterial therapies

    • Bland embolization

    • Chemoembolization (Trans-arterial Chemoembolization [TACE]).

      • Conventional

      • Drug-Eluting Beads (DEB) based

  • Radioembolization (transarterial radioembolization [TARE]).

  • Other adjunct procedures such as portal vein embolization (PVE).



Publication History

Received: 18 December 2019

Accepted: 02 July 2020

Article published online:
17 May 2021

© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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