Treatment options and surveillance strategies after therapy for hepatocellular carcinoma

Ioannis Hatzaras, Danielle A. Bischof, Bridget Fahy, David Cosgrove, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and the third leading cause of cancer death worldwide. Recurrence rates after curative intent treatment for HCC are high; 5-year disease-free survival ranges from only 19 to 81 %. There is no direct evidence to guide the optimal frequency and method of surveillance for recurrent HCC after curative intent treatment. In contrast, there is strong evidence supporting both primary screening for HCC in patients with chronic liver disease. After resection, HCC tends to recur locally, whereas the pattern after transplantation is more at extrahepatic sites. In theory, if an HCC recurrence is discovered early, more therapeutic options are available for treatment of the recurrent HCC. As such, close surveillance after curative intent therapy may have the potential to prolong survival. We herein review the available literature derived from primary surveillance of patients with cirrhosis, as well as data on postoperative surveillance of HCC patients. In aggregate, although data remain scarce, close surveillance with α-fetoprotein and cross-sectional imaging every 3-4 months for 3 years after curative intent therapy, followed by surveillance every 6-12 months thereafter, seems the most prudent approach to follow-up of patients with HCC in the postsurgical setting.

Original languageEnglish (US)
Pages (from-to)758-766
Number of pages9
JournalAnnals of Surgical Oncology
Volume21
Issue number3
DOIs
StatePublished - Mar 2014

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Hepatocellular Carcinoma
Therapeutics
Fetal Proteins
Recurrence
Disease-Free Survival
Liver Diseases
Cause of Death
Neoplasms
Fibrosis
Chronic Disease
Transplantation
Survival
Liver

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Treatment options and surveillance strategies after therapy for hepatocellular carcinoma. / Hatzaras, Ioannis; Bischof, Danielle A.; Fahy, Bridget; Cosgrove, David; Pawlik, Timothy M.

In: Annals of Surgical Oncology, Vol. 21, No. 3, 03.2014, p. 758-766.

Research output: Contribution to journalArticle

Hatzaras, Ioannis ; Bischof, Danielle A. ; Fahy, Bridget ; Cosgrove, David ; Pawlik, Timothy M. / Treatment options and surveillance strategies after therapy for hepatocellular carcinoma. In: Annals of Surgical Oncology. 2014 ; Vol. 21, No. 3. pp. 758-766.
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