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Erschienen in: Wiener Medizinische Wochenschrift 21-22/2014

01.11.2014 | main topic

Hepatocellular carcinoma

verfasst von: Maria Daoudaki, PhD, Ioannis Fouzas, MD, PhD

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 21-22/2014

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Summary

Hepatocellular carcinoma (HCC) is a heterogeneous tumor with many factors implicated in its development, with chronic infection and cirrhosis by hepatitis B virus (HBV) being the most prevalent. Cirrhosis due to metabolic syndrome, alcohol consumption, viral infection with hepatitis C virus (HCV) is also involved in its development. Treatment of HCC remains unsatisfactory. Therapeutic management for HCC includes liver transplantation, liver resection, ablation, chemoembolization, which depend on the tumor stage, liver function, and patient performance status. The involvement of different signaling pathways in the initiation and modulation of HCC development based on clinical and research data provided a strong rationale for the development of anti-cancer agents targeting key components of the pathways. The complexity of the tumor prevents the major goal of this therapeutic approach, since sorafenib, a multi-kinase inhibitor, is the only successful drug so far that belongs to the target directed therapy in advanced stage HCC.
Literatur
1.
Zurück zum Zitat Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.PubMedCrossRef Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.PubMedCrossRef
3.
Zurück zum Zitat Beasley RP. Hepatitis B virus. The major etiology of hepatocellular carcinoma. Cancer. 1988;61:1942–56.PubMedCrossRef Beasley RP. Hepatitis B virus. The major etiology of hepatocellular carcinoma. Cancer. 1988;61:1942–56.PubMedCrossRef
4.
Zurück zum Zitat Chen CJ, Yu MW, Liaw YF. Epidemiological characteristics and risk factors of hepatocellular carcinoma. J Gastroenterol Hepatol. 1997;12:S294–308.PubMedCrossRef Chen CJ, Yu MW, Liaw YF. Epidemiological characteristics and risk factors of hepatocellular carcinoma. J Gastroenterol Hepatol. 1997;12:S294–308.PubMedCrossRef
5.
Zurück zum Zitat Hassan MM, Hwang LY, Hatten CJ, et al. Risk factors for hepatocellular carcinoma: synergism of alcohol with viral hepatitis and diabetes mellitus. Hepatology. 2002;36:1206–13.PubMedCrossRef Hassan MM, Hwang LY, Hatten CJ, et al. Risk factors for hepatocellular carcinoma: synergism of alcohol with viral hepatitis and diabetes mellitus. Hepatology. 2002;36:1206–13.PubMedCrossRef
6.
Zurück zum Zitat Lin CW, Lin CC, Mo LR, et al. Heavy alcohol consumption increases the incidence of hepatocellular carcinoma in hepatitis B virus-related cirrhosis. J Hepatol. 2013;58:730–5.PubMedCrossRef Lin CW, Lin CC, Mo LR, et al. Heavy alcohol consumption increases the incidence of hepatocellular carcinoma in hepatitis B virus-related cirrhosis. J Hepatol. 2013;58:730–5.PubMedCrossRef
7.
Zurück zum Zitat El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007;132:2557–76.PubMedCrossRef El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007;132:2557–76.PubMedCrossRef
10.
Zurück zum Zitat Weihrauch M, Benick M, Lehner G, et al. High prevalence of K-ras-2 mutations in hepatocellular carcinomas in workers exposed to vinyl chloride. Int Arch Occup Environ Health. 2001;74:405–10.PubMedCrossRef Weihrauch M, Benick M, Lehner G, et al. High prevalence of K-ras-2 mutations in hepatocellular carcinomas in workers exposed to vinyl chloride. Int Arch Occup Environ Health. 2001;74:405–10.PubMedCrossRef
11.
Zurück zum Zitat Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001;357:539–45.PubMedCrossRef Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001;357:539–45.PubMedCrossRef
12.
Zurück zum Zitat Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature. 2008;454:436–44. Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature. 2008;454:436–44.
13.
Zurück zum Zitat European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56:908–43. European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56:908–43.
14.
Zurück zum Zitat Pikarsky E, Porat RM, Stein I, et al. NF-kappaB functions as a tumour promoter in inflammation-associated cancer. Nature. 2004;431:461–6.PubMedCrossRef Pikarsky E, Porat RM, Stein I, et al. NF-kappaB functions as a tumour promoter in inflammation-associated cancer. Nature. 2004;431:461–6.PubMedCrossRef
15.
Zurück zum Zitat Bollrath J, Greten FR. IKK/NF-kappaB and STAT3 pathways: central signalling hubs in inflammation-mediated tumour promotion and metastasis. EMBO Rep. 2009;10:1314–9.PubMedCentralPubMedCrossRef Bollrath J, Greten FR. IKK/NF-kappaB and STAT3 pathways: central signalling hubs in inflammation-mediated tumour promotion and metastasis. EMBO Rep. 2009;10:1314–9.PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Luedde T, Schwabe RF. NF-κB in the liver–linking injury, fibrosis and hepatocellular carcinoma. Nat Rev Gastroenterol Hepatol. 2011;8:108–18.PubMedCentralPubMedCrossRef Luedde T, Schwabe RF. NF-κB in the liver–linking injury, fibrosis and hepatocellular carcinoma. Nat Rev Gastroenterol Hepatol. 2011;8:108–18.PubMedCentralPubMedCrossRef
17.
Zurück zum Zitat Vucur M, Roderburg C, Bettermann K, et al. Mouse models of hepatocarcinogenesis: what can we learn for the prevention of human hepatocellular carcinoma? Oncotarget. 2010;1:373–8.PubMedCentralPubMed Vucur M, Roderburg C, Bettermann K, et al. Mouse models of hepatocarcinogenesis: what can we learn for the prevention of human hepatocellular carcinoma? Oncotarget. 2010;1:373–8.PubMedCentralPubMed
18.
Zurück zum Zitat Bettermann K, Vucur M, Haybaeck J, et al. TAK1 suppresses a NEMO-dependent but NF-kappaB-independent pathway to liver cancer. Cancer Cell. 2010;17:481–96.PubMedCrossRef Bettermann K, Vucur M, Haybaeck J, et al. TAK1 suppresses a NEMO-dependent but NF-kappaB-independent pathway to liver cancer. Cancer Cell. 2010;17:481–96.PubMedCrossRef
19.
Zurück zum Zitat Liu P, Kimmoun E, Legrand A, et al. Activation of NF-kappa B, AP-1 and STAT transcription factors is a frequent and early event in human hepatocellular carcinomas. J Hepatol. 2002;37:63–71.PubMedCrossRef Liu P, Kimmoun E, Legrand A, et al. Activation of NF-kappa B, AP-1 and STAT transcription factors is a frequent and early event in human hepatocellular carcinomas. J Hepatol. 2002;37:63–71.PubMedCrossRef
20.
Zurück zum Zitat Pang RW, Joh JW, Johnson PJ, et al. Biology of hepatocellular carcinoma. Ann Surg Oncol. 2008;15:962–71.PubMedCrossRef Pang RW, Joh JW, Johnson PJ, et al. Biology of hepatocellular carcinoma. Ann Surg Oncol. 2008;15:962–71.PubMedCrossRef
21.
Zurück zum Zitat Capece D, Fischietti M, Verzella D, et al. The inflammatory microenvironment in hepatocellular carcinoma: a pivotal role for tumor-associated macrophages. Biomed Res Int. 2013;2013:1–14.CrossRef Capece D, Fischietti M, Verzella D, et al. The inflammatory microenvironment in hepatocellular carcinoma: a pivotal role for tumor-associated macrophages. Biomed Res Int. 2013;2013:1–14.CrossRef
23.
Zurück zum Zitat Gao B, Wang H, Lafdil F, Feng D. STAT proteins – key regulators of anti-viral responses, inflammation, and tumorigenesis in the liver. J Hepatol. 2012;57:430–41.PubMedCentralPubMedCrossRef Gao B, Wang H, Lafdil F, Feng D. STAT proteins – key regulators of anti-viral responses, inflammation, and tumorigenesis in the liver. J Hepatol. 2012;57:430–41.PubMedCentralPubMedCrossRef
24.
Zurück zum Zitat Ramakrishna G, Rastogi A, Trehanpati N, et al. From cirrhosis to hepatocellular carcinoma: new molecular insights on inflammation and cellular senescence. Liver Cancer. 2013;2:367–83.PubMedCentralPubMedCrossRef Ramakrishna G, Rastogi A, Trehanpati N, et al. From cirrhosis to hepatocellular carcinoma: new molecular insights on inflammation and cellular senescence. Liver Cancer. 2013;2:367–83.PubMedCentralPubMedCrossRef
25.
Zurück zum Zitat Kan Z, Zheng H, Liu X, et al. Whole-genome sequencing identifies recur-rent mutations in hepatocellular carcinoma. Genome Res. 2013;23:1422–33.PubMedCentralPubMedCrossRef Kan Z, Zheng H, Liu X, et al. Whole-genome sequencing identifies recur-rent mutations in hepatocellular carcinoma. Genome Res. 2013;23:1422–33.PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Cleary SP, Jeck WR, Zhao X, et al. Identification of driver genes in hepa-tocellular carcinoma by exome sequencing. Hepatology. 2013;58:1693–702.PubMedCentralPubMedCrossRef Cleary SP, Jeck WR, Zhao X, et al. Identification of driver genes in hepa-tocellular carcinoma by exome sequencing. Hepatology. 2013;58:1693–702.PubMedCentralPubMedCrossRef
27.
Zurück zum Zitat Nault JC, Zucman-Rossi J. Genetics of hepatocellular carcinoma: the next generation. J Hepatol. 2014;60:224–6.PubMedCrossRef Nault JC, Zucman-Rossi J. Genetics of hepatocellular carcinoma: the next generation. J Hepatol. 2014;60:224–6.PubMedCrossRef
28.
Zurück zum Zitat Chaiteerakij R, Roberts LR. Genetic alterations in advanced HBV-related HCC with portal vein tumor thrombosis: insights from next generation DNA sequencing. J Hepatol. 2013;58:1042–4.PubMedCrossRef Chaiteerakij R, Roberts LR. Genetic alterations in advanced HBV-related HCC with portal vein tumor thrombosis: insights from next generation DNA sequencing. J Hepatol. 2013;58:1042–4.PubMedCrossRef
29.
Zurück zum Zitat Ji J, Wang XW. New kids on the block: diagnostic and prognostic microRNAs in hepatocellular carcinoma. Cancer Biol Ther. 2009;8:1686–93.PubMedCrossRef Ji J, Wang XW. New kids on the block: diagnostic and prognostic microRNAs in hepatocellular carcinoma. Cancer Biol Ther. 2009;8:1686–93.PubMedCrossRef
30.
Zurück zum Zitat Sun J, Lu H, Wang X, et al. MicroRNAs in hepatocellular carcinoma: regulation, function, and clinical implications. ScientificWorldJournal. 2013;1:1–37. Sun J, Lu H, Wang X, et al. MicroRNAs in hepatocellular carcinoma: regulation, function, and clinical implications. ScientificWorldJournal. 2013;1:1–37.
31.
Zurück zum Zitat Behne T, Copur MS. Biomarkers for hepatocellular carcinoma. Int J Hepatol. 2012;2012:1–7.CrossRef Behne T, Copur MS. Biomarkers for hepatocellular carcinoma. Int J Hepatol. 2012;2012:1–7.CrossRef
32.
Zurück zum Zitat Malek NP, Schmidt S, Huber P, Manns MP, Greten TF. The diagnosis and treatment of hepatocelular carcinoma. Dtsch Arztebl Int. 2014;111:101–6.PubMedCentralPubMed Malek NP, Schmidt S, Huber P, Manns MP, Greten TF. The diagnosis and treatment of hepatocelular carcinoma. Dtsch Arztebl Int. 2014;111:101–6.PubMedCentralPubMed
33.
Zurück zum Zitat Shigoka M, Tsuchida A, Matsudo T, et al. Deregulation of miR-92a expression is implicated in hepatocellular carcinoma development. Pathol Int. 2010;60:351–7.PubMedCrossRef Shigoka M, Tsuchida A, Matsudo T, et al. Deregulation of miR-92a expression is implicated in hepatocellular carcinoma development. Pathol Int. 2010;60:351–7.PubMedCrossRef
34.
Zurück zum Zitat Chen X, Ba Y, Ma L, et al. Characterization of microRNAs in serum: a novel class of biomarkers for diagnosis of cancer and other diseases. Cell Res. 2008;18:997–1006.PubMedCrossRef Chen X, Ba Y, Ma L, et al. Characterization of microRNAs in serum: a novel class of biomarkers for diagnosis of cancer and other diseases. Cell Res. 2008;18:997–1006.PubMedCrossRef
35.
Zurück zum Zitat Sherman M. Primary malignant neoplasms of the liver. In: Dooley JS, Lok ASF, Burroughs AK, Heathcote EJ, editors. Sherlock’s diseases of the liver and biliary system. 12th ed. Chapter 35. Chichester: John Wiley & Sons Ltd; 2011. pp. 681–703. Sherman M. Primary malignant neoplasms of the liver. In: Dooley JS, Lok ASF, Burroughs AK, Heathcote EJ, editors. Sherlock’s diseases of the liver and biliary system. 12th ed. Chapter 35. Chichester: John Wiley & Sons Ltd; 2011. pp. 681–703.
36.
Zurück zum Zitat Forner A, Vilana R, Ayuso C, et al. Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology. 2008;47:97–104.PubMedCrossRef Forner A, Vilana R, Ayuso C, et al. Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology. 2008;47:97–104.PubMedCrossRef
37.
Zurück zum Zitat Schirmacher P, Bedossa P, Roskams T, et al. Fighting the bushfire in HCC trials. J Hepatol. 2011;55:276–7.PubMedCrossRef Schirmacher P, Bedossa P, Roskams T, et al. Fighting the bushfire in HCC trials. J Hepatol. 2011;55:276–7.PubMedCrossRef
39.
Zurück zum Zitat Colombo M, Raoul JL, Lencioni R, et al. Multidisciplinary strategies to improve treatment outcomes in hepatocellular carcinoma: a European perspective. Eur J Gastroenterol Hepatol. 2013;25:639–51.PubMedCrossRef Colombo M, Raoul JL, Lencioni R, et al. Multidisciplinary strategies to improve treatment outcomes in hepatocellular carcinoma: a European perspective. Eur J Gastroenterol Hepatol. 2013;25:639–51.PubMedCrossRef
40.
Zurück zum Zitat Lim C, Farges O. Primary malignant tumors of the liver. In: Garden OJ, Parks RW, editors. Hepatobiliary and pancreatic surgery. A companion to specialist surgical practice. 5th ed. Chapter 5. Edinburgh: Saunders-Elsevier; 2014. pp. 80–108. Lim C, Farges O. Primary malignant tumors of the liver. In: Garden OJ, Parks RW, editors. Hepatobiliary and pancreatic surgery. A companion to specialist surgical practice. 5th ed. Chapter 5. Edinburgh: Saunders-Elsevier; 2014. pp. 80–108.
41.
Zurück zum Zitat Edge SB, Byrd DR, Compton CC, et al. “AJCC Cancer Staging Manual”, American Joint Committee on Cancer. 7th ed. Springer; 2010. Edge SB, Byrd DR, Compton CC, et al. “AJCC Cancer Staging Manual”, American Joint Committee on Cancer. 7th ed. Springer; 2010.
42.
Zurück zum Zitat Okuda K, Ohtsuki T, Obata H, et al. Natural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patients. Cancer. 1985;56:918–28.PubMedCrossRef Okuda K, Ohtsuki T, Obata H, et al. Natural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patients. Cancer. 1985;56:918–28.PubMedCrossRef
43.
Zurück zum Zitat Llovet JM, Bru C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999;19:329–38.PubMedCrossRef Llovet JM, Bru C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999;19:329–38.PubMedCrossRef
44.
Zurück zum Zitat The Cancer of the Liver Italian Program (CLIP) investigators. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients. Hepatology. 1998;28:751–5. The Cancer of the Liver Italian Program (CLIP) investigators. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients. Hepatology. 1998;28:751–5.
45.
Zurück zum Zitat Leung TW, Tang AM, Zee B, et al. Construction of the Chinese University Prognostic Index for hepatocellular carcinoma and comparison with the TNM staging system, the Okuda staging system, and the Cancer of the Liver Italian Program staging system: a study based on 926 patients. Cancer. 2002;94:1760–176.PubMedCrossRef Leung TW, Tang AM, Zee B, et al. Construction of the Chinese University Prognostic Index for hepatocellular carcinoma and comparison with the TNM staging system, the Okuda staging system, and the Cancer of the Liver Italian Program staging system: a study based on 926 patients. Cancer. 2002;94:1760–176.PubMedCrossRef
46.
Zurück zum Zitat Kudo M, Chung H, Osaki Y. Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging Score (JIS score). J Gastroenterol. 2003;38:207–15.PubMedCrossRef Kudo M, Chung H, Osaki Y. Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, the Japan Integrated Staging Score (JIS score). J Gastroenterol. 2003;38:207–15.PubMedCrossRef
47.
Zurück zum Zitat Chevret S, Trinchet JC, Mathieu D, et al. A new prognostic classification for predicting survival in patients with hepatocellular carcinoma. Groupe d’Etude et de Traitement du Carcinome Hepatocellulaire. J Hepatol. 1999;31:133–41.PubMedCrossRef Chevret S, Trinchet JC, Mathieu D, et al. A new prognostic classification for predicting survival in patients with hepatocellular carcinoma. Groupe d’Etude et de Traitement du Carcinome Hepatocellulaire. J Hepatol. 1999;31:133–41.PubMedCrossRef
48.
Zurück zum Zitat Marrero JA, Fontana RJ, Barrat A, et al. Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort. Hepatology. 2005;41:707–15.PubMedCrossRef Marrero JA, Fontana RJ, Barrat A, et al. Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort. Hepatology. 2005;41:707–15.PubMedCrossRef
49.
Zurück zum Zitat Smoot RL, Nagorney DM, Chandan VS, et al. Resection of hepatocellular carcinoma in patients without cirrhosis. Br J Surg. 2011;98:697–703.PubMedCrossRef Smoot RL, Nagorney DM, Chandan VS, et al. Resection of hepatocellular carcinoma in patients without cirrhosis. Br J Surg. 2011;98:697–703.PubMedCrossRef
50.
Zurück zum Zitat Mergental H, Adam R, Ericzon BG, et al. Liver transplantation for unresectable hepatocellular carcinoma in normal livers. J Hepatol. 2012;57:297–305.PubMedCrossRef Mergental H, Adam R, Ericzon BG, et al. Liver transplantation for unresectable hepatocellular carcinoma in normal livers. J Hepatol. 2012;57:297–305.PubMedCrossRef
51.
Zurück zum Zitat Palavecino M, Chun YS, Madoff DC, et al. Major hepatic resection for hepatocellular carcinoma with or without portal vein embolization: perioperative outcome and survival. Surgery. 2009;145:399–405.PubMedCrossRef Palavecino M, Chun YS, Madoff DC, et al. Major hepatic resection for hepatocellular carcinoma with or without portal vein embolization: perioperative outcome and survival. Surgery. 2009;145:399–405.PubMedCrossRef
52.
Zurück zum Zitat Vennarecci G, Laurenzi A, Santoro R, et al. The ALPPS procedure: a surgical option for hepatocellular carcinoma with major vascular invasion. World J Surg. 2014;38:1498–503.PubMedCrossRef Vennarecci G, Laurenzi A, Santoro R, et al. The ALPPS procedure: a surgical option for hepatocellular carcinoma with major vascular invasion. World J Surg. 2014;38:1498–503.PubMedCrossRef
53.
Zurück zum Zitat Fouzas I, Sotiropoulos GC, Sgourakis G, et al. Five-year survival after monotherapy for hepatocellular carcinoma in the setting of cirrhosis. Transplant Proc. 2008;40:3204–5.PubMedCrossRef Fouzas I, Sotiropoulos GC, Sgourakis G, et al. Five-year survival after monotherapy for hepatocellular carcinoma in the setting of cirrhosis. Transplant Proc. 2008;40:3204–5.PubMedCrossRef
54.
Zurück zum Zitat Mazzaferro V, Bhoori S, Sposito C, et al. Milan criteria in liver transplantation for HCC: an evidence-based analysis on 15 years of experience. Liver Transpl. 2011;17:S44–57.PubMedCrossRef Mazzaferro V, Bhoori S, Sposito C, et al. Milan criteria in liver transplantation for HCC: an evidence-based analysis on 15 years of experience. Liver Transpl. 2011;17:S44–57.PubMedCrossRef
55.
Zurück zum Zitat Clavien PA, Lesurtel M, Bossuyt PM, et al. On behalf of the OLT for HCC consensus group. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. Lancet Oncol. 2012;13:11–22. Clavien PA, Lesurtel M, Bossuyt PM, et al. On behalf of the OLT for HCC consensus group. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. Lancet Oncol. 2012;13:11–22.
56.
Zurück zum Zitat Heckman JT, Devera MB, Marsh JW, et al. Bridging locoregional therapy for hepatocellular carcinoma prior to liver transplantation. Ann Surg Oncol. 2008;15:3169–77.PubMedCrossRef Heckman JT, Devera MB, Marsh JW, et al. Bridging locoregional therapy for hepatocellular carcinoma prior to liver transplantation. Ann Surg Oncol. 2008;15:3169–77.PubMedCrossRef
57.
Zurück zum Zitat Fouzas I, Sotiropoulos GC, Lang H, et al. Living donor liver transplantation for hepatocellular carcinoma in patients exceeding the UCSF criteria. Transplant Proc. 2008;40:3185–8.PubMedCrossRef Fouzas I, Sotiropoulos GC, Lang H, et al. Living donor liver transplantation for hepatocellular carcinoma in patients exceeding the UCSF criteria. Transplant Proc. 2008;40:3185–8.PubMedCrossRef
58.
Zurück zum Zitat Cho YK, Kim JK, Kim WT, et al. Hepatic resection versus radiofrequency ablation for very early stage hepatocellular carcinoma: a Markov model analysis. Hepatology. 2010;51:1284–90.PubMedCrossRef Cho YK, Kim JK, Kim WT, et al. Hepatic resection versus radiofrequency ablation for very early stage hepatocellular carcinoma: a Markov model analysis. Hepatology. 2010;51:1284–90.PubMedCrossRef
59.
Zurück zum Zitat Poggi G, Montagna B, DI Cesare P, et al. Microwave ablation of hepatocellular carcinoma using a new percutaneous device: preliminary results. Anticancer Res. 2013;33:1221–7.PubMed Poggi G, Montagna B, DI Cesare P, et al. Microwave ablation of hepatocellular carcinoma using a new percutaneous device: preliminary results. Anticancer Res. 2013;33:1221–7.PubMed
60.
Zurück zum Zitat Zhu AX. Systemic therapy of advanced hepatocellular carcinoma: how hopeful should we be? Oncologist. 2006;11:790–800.PubMedCrossRef Zhu AX. Systemic therapy of advanced hepatocellular carcinoma: how hopeful should we be? Oncologist. 2006;11:790–800.PubMedCrossRef
61.
62.
Zurück zum Zitat Llovet JM, Ricci S, Mazzaferro V, et al. SHARP investigators study group sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359:378–90.PubMedCrossRef Llovet JM, Ricci S, Mazzaferro V, et al. SHARP investigators study group sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359:378–90.PubMedCrossRef
63.
Metadaten
Titel
Hepatocellular carcinoma
verfasst von
Maria Daoudaki, PhD
Ioannis Fouzas, MD, PhD
Publikationsdatum
01.11.2014
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 21-22/2014
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-014-0296-7

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