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Review

The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma

1
Department of Radiology, King Saud University, Riyadh, Saudi Arabia
2
Section of Hepatopancreatobiliary and Transplant Surgery, McGill University Health Centre, Montreal, QC, USA
3
Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
4
Department of Radiology, McGill University Health Centre, Montreal, QC, USA
5
‖Department of Surgery, King Saud University, Riyadh, Saudi Arabia
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2014, 21(3), 480-492; https://doi.org/10.3747/co.21.1829
Submission received: 4 March 2014 / Revised: 8 April 2014 / Accepted: 7 May 2014 / Published: 1 June 2014

Abstract

Background: Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related death worldwide. Overall, liver transplantation and resection are the only available treatments with potential for cure. Various locoregional therapies are widely used to manage patients with advanced HCC or as a bridging therapy for patients with early and intermediate disease. This article reviews and evaluates the role of interventional radiology in the management of such cases by assessing various aspects of each method, such as effect on rates of survival, recurrence, tumour response, and complications. Methods: A systemic search of PubMed, MEDLINE, Ovid Medline In-Process, and the Cochrane Database of Systematic Reviews retrieved all related scientific papers for review. Results: Needle core biopsy is a highly sensitive, specific, and accurate method for HCC grading. Portal-vein embolization provides adequate expansion of the future liver remnant, making more patients eligible for resection. In focal or multifocal unresectable early-stage disease, radiofrequency ablation tops all other thermoablative methods. However, microwave ablation is preferred in large tumours and in patients with Child–Pugh B disease. Cryoablation is preferred in recurrent disease and in patients who are poor candidates for anesthesia. Of the various transarterial modalities—transarterial chemoembolization (TACE), drug-eluting beads, and transarterial radioembolization (TARE)—TACE is the method of choice in Child–Pugh A disease, and TARE is the method of choice in HCC cases with portal vein thrombosis. Conclusions: The existing data support the importance of a multidisciplinary approach in HCC management. Large randomized controlled studies are needed to provide clear indication guidelines for each method.
Keywords: interventional radiology; hepatocellular carcinoma; liver biopsy; ablation; embolization; drug-eluting beads interventional radiology; hepatocellular carcinoma; liver biopsy; ablation; embolization; drug-eluting beads

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MDPI and ACS Style

Molla, N.; AlMenieir, N.; Simoneau, E.; Aljiffry, M.; Valenti, D.; Metrakos, P.; Boucher, L.M.; Hassanain, M. The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma. Curr. Oncol. 2014, 21, 480-492. https://doi.org/10.3747/co.21.1829

AMA Style

Molla N, AlMenieir N, Simoneau E, Aljiffry M, Valenti D, Metrakos P, Boucher LM, Hassanain M. The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma. Current Oncology. 2014; 21(3):480-492. https://doi.org/10.3747/co.21.1829

Chicago/Turabian Style

Molla, N., N. AlMenieir, E. Simoneau, M. Aljiffry, D. Valenti, P. Metrakos, L.M. Boucher, and M. Hassanain. 2014. "The Role of Interventional Radiology in the Management of Hepatocellular Carcinoma" Current Oncology 21, no. 3: 480-492. https://doi.org/10.3747/co.21.1829

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