Preview

Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery

Advanced search

Modern principles of hepatocellular carcinoma treatment

https://doi.org/10.16931/1995-5464.2020215-26

Abstract

Aim. To improve the treatment outcomes, quality and life expectancy, prognosis in patients with hepatocellular carcinoma based on an analysis of treatment outcomes.

Materials and methods. The analysis of the long-term results of treatment of 114 patients with hepatocellular carcinoma for 2015–2020 was carried out. Two groups of patients were distinguished: 41 (35.9%) patients were included in group I (a potentially resectable tumor with R0 surgery), and 63 (55.2%) patients were included in group II (advanced tumor does not suggest R0 resection).

Results. Actuarial survival for patients with R0 surgery (48) was: 1 year – 85%, 3 years – 65%, 5 years – 55%; in patients with unresectable tumor after transarterial chemoembolization: 1 year – 65%, 3 years – 29%, 5 years – 11%; after local destruction methods – 0.5 years – 75%, 1 year – 36%, 1.5 years – 22%.

Conclusions. The results of treatment of patients with hepatocellular carcinoma confirm the feasibility and effectiveness of a rational multidisciplinary approach. It allows you to achieve satisfactory results in multidisciplinary hospitals. The results are consistent with the data of large surgical centers.

About the Authors

V. A. Vishnevsky
Vishnevsky National Medical Research Center of Surgery

Vladimir A. Vishnevsky – Doct. of Sci. (Med.), Professor, Advisor to the Director

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



Kh. A. Ayvazyan
Vishnevsky National Medical Research Center of Surgery
Russian Federation

Khachik H. Ayvazyan – Junior Researcher of the Oncology Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



R. Z. Ikramov
Vishnevsky National Medical Research Center of Surgery

Ravshan Z. Ikramov – Doct. of Sci. (Med.), Chief Researcher of Oncology Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



D. A. Ionkin
Vishnevsky National Medical Research Center of Surgery

Dmitry A. Ionkin – Cand. of Sci. (Med.), Surgeon of the Oncology Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



O. I. Zhavoronkova
Vishnevsky National Medical Research Center of Surgery

Olga I. Zhavoronkova – Cand. of Sci. (Med.), Senior Researcher, Ultrasound Diagnostics Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



Yu. A. Stepanova
Vishnevsky National Medical Research Center of Surgery

Yulia A. Stepanova – Doct. of Sci. (Med.), Scientific Secretary

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



A. B. Varava
Vishnevsky National Medical Research Center of Surgery

Alexey B. Varava – Junior Researcher of the Interventional Surgery Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



Yu. A. Kovalenko
Vishnevsky National Medical Research Center of Surgery

Yuri A. Kovalenko – Doct. of Sci. (Med.), Senior Researcher of the Oncology Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



Yu. O. Zharikov
Sklifosovsky Institute of Clinical Medicine of I.M. Sechenov First Moscow State Medical University

Yuri O. Zharikov – Cand. of Sci. (Med.), Associate professor of the Anatomy Department

3, bldg. 1, Bolshaya Sukharevskaya sq., Moscow, 129090



A. B. Goncharov
Vishnevsky National Medical Research Center of Surgery

Anton B. Goncharov – Junior Researcher of the Oncology Department

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



A. A. Olifir
Vishnevsky National Medical Research Center of Surgery

Anna A. Olifir – Graduate Student in Surgery

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



A. Yu. Pakhomova
Vishnevsky National Medical Research Center of Surgery

Anastasia Y. Pakhomova – Clinical Resident in Surgery

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



S. A. Bugaev
Vishnevsky National Medical Research Center of Surgery

Sergey A. Bugaev – Cand. of Sci. (Med.), Adviser to the Director

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



A. V. Zhao
Vishnevsky National Medical Research Center of Surgery

Alexey V. Zhao – Doct. of Sci. (Med.), Professor, Deputy Director

d. 27, Bolshaya Serpukhovskaya str., Moscow, 117997



References

1. Fitzmaurice C., Allen C., Barber R.M. et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups,1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017; 3 (4): 524– 548. https://doi.org/10.1001/jamaoncol.2016.5688.

2. El-Serag H.B., Rudolph K.L. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007; 132 (7): 2557–2576. https://doi.org/10.1053/j.gastro2007.04.061

3. El-Serag H.B. Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology. 2012; 14 (6); 1264–1273.e.1261. https://doi.org/10.1053/j.gastro.2011.12.061

4. Tang A., Hallouch O., Chernyak V., Kamaya A. Sirlin C.B. Epidemiology of hepatocellular carcinoma: target population for surveillance and diagnosis. Abdom. Radiol. (NY). 2018; 43 (1): 13–25. https://doi.org/10.1007/s00261-017-1209-1.

5. Liu J., Fan D. Hepatitis B in China. The Lancet. 2007; 369 (9573): 1582–1583. https://doi.org/10.1016/S0140-6736(07)60723-5

6. Ferenci P., Fried M., Labrecque D., Bruix J., Sherman M., Omata M., Heathcote J., Piratsivuth T., Kew M., Otegbayo J.A., Zheng S.S., Sarin S., Hamid S., Modawi S.B., Fleig W., Fedail S., Thomson A., Khan A., Malfertheiner P., Lau G., Carillo F.J., Krabshuis J., Le Mair A.; World Gastroenterology Organisation Guidelines and Publications Committee. World gastro enterology organization guideline. Hepatocellular carcinoma (HCC): a global perspective. J. Gastrointest. Liver Dis. 2010; 19 (3): 311–317. https://doi.org/10.1016/S1470-2045(09)70241-4.

7. Poon D., Anderson B.O., Chen L.T., Tanaka K., Lau W.Y., Van Cutsem E., Singh H., Chow W.C., Ooi L.L., Chow P., Khin M.W., Koo W.H.; Asian Oncology Summit. Management of hepatocellular carcinoma in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol. 2009; 10 (11): 1111–1118.

8. Yuen M.F., Hou J.L., Chutaputti A. Hepatocellular carcinoma in the Asia Pacific region. J. Gastroenterol. Hepatol. 2009; 24 (3): 346–353. https://doi.org/10.1111/j.1440-1746.2009.05784.x

9. Altekruse S.F., McGlynn K.A., Reichman M.E. Hepatocellular carcinoma incidence, mortality, and survival trends in the United States from 1975 to 2005. J. Clin. Oncol. 2009; 27 (9): 1485–1491. https://doi.org/10.1200/JCO.2008.20.7753

10. Hajarizadeh B., Grebely J., Dore G.J. Epidemiology and natural history of HCV infection. Nat. Rev. Gastroenterol. Hepatol. 2013; 10 (9): 553–562. https://doi.org/10.1038/nrgastro.2013.107

11. Sherman M. Epidemiology of hepatocellular carcinoma. Oncology. 2010; 78 (1): 7–10. https://doi.org/10.1016/j.idc.2010.07.004

12. Ahn J., Flamm S.L. Hepatocellular Carcinoma. Disease-aMonth. 2004; 50 (10): 556–573.

13. Nordenstedt H., White D.L., El-Serag H.B. The changing pattern of epidemiology in hepatocellular carcinoma. Dig. Liver Dis. 2010; 42 (Suppl.3): S206–214. https://doi.org/10.1016/S1590-8658(10)60507-5

14. Umemura T., Ichijo T., Yoshizawa K., Tanaka E., Kiyosawa K. Epidemiology of hepatocellular carcinoma in Japan. J. Gastroenterol. 2009; 44 (19): 102–107. https://doi.org/10.1111/liv.12818

15. Park J.W., Chen M., Colombo M., Roberts L.R., Schwartz M., Chen P.J., Kudo M., Johnson P., Wagner S., Orsini L.S., Sherman M. Global patterns of hepatocellular carcinoma management from diagnosis to death: the bridge study. Liver Int. 2015; 35 (9): 2155–2166.

16. Yang J.D., Mohamed E.A., Aziz A.O. et al. Africa Network for Gastrointestinal and Liver Diseases. Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium. Lancet Gastroenterol. Hepatol. 2017; 2 (2): 103–111. https://doi.org/10.1016/S2468-1253(16)30161-3

17. Kudo M. Management of hepatocellular carcinoma in Japan as a world-leading model. Liver Cancer. 2018; 7 (2): 134–147. https://doi.org/10.1159/000484619

18. Okuda K., Ohtsuki T., Obata H., Tomimatsu M., Okazaki N., Hasegawa H., Nakajima Y., Ohnishi K. Natural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patients. Cancer. 1985; 56 (4): 918–928. https://doi.org/10.1002/1097-0142(19850815)56:43.0.co;2-e

19. Yau T., Tang V.Y., Yao T.J., Fan S.T., Lo C.M., Poon R.T. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients: the Cancer of the Liver Italian Program (CLIP) investigators. Hepatology. 1998; 28 (3): 751–755. https://doi.org/10.1002/hep.510280322

20. Llovet J.M., Br C., Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin. Liver Dis. 1999; 19 (3): 329–338. https://doi.org/10.1055/s-2007-1007122

21. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012 v1.0. IARC CancerBase No.11. Edited by Ferlay J., Soerjomataram I., Ervik M., Dikshit R., Eser S., Mathers C., Rebelo M., Parkin D.M., Forman D., Bray F. https://publications.iarc.fr/Databases/Iarc-Cancerbases/GLOBOCAN-2012-Estimated-Cancer-Incidence-MortalityAnd-Prevalence-Worldwide-In-2012-V1.0-2012 (accessed on 31.03.2020)

22. Hsu C.Y., Huang Y.H., Hsia C.Y.,Su C.W., Lin H.C., Loong C.С.,Chiou Y.Y., Chiang J.H., Lee P.С., Huo T.I., Lee S.D. A new prognostic model for hepatocellular carcinoma based on total tumor volume: The Taipei Integrated Scoring system. J. Hepatol. 2010; 53 (1): 108–117. https://doi.org/10.1016/j.jhep.2010.01.038

23. Yau T., Tang V.Y., Yao T.J., Fan S.T., Lo C.M., Poon R.T. Development of Hong Kong Liver Cancer staging system with treatment stratification for patients with hepatocellular carcinoma. Gastroenterology. 2014; 146 (7): 1691–1700.e3. https://doi.org/10.1053/j.gastro.2014.02.032.

24. Kane M.A. Global control of primary hepatocellular carcinoma with hepatitis B vaccine: the contributions of research in Taiwan. Cancer Epidemiol. Biomarkers Prev. 2003; 12 (1): 2–3.

25. Bellissimo F., Pinzone M.R., Cacopardo B., Nunnari G. Diagnostic and therapeutic management of hepatocellular carcinoma. World J. Gastroenterol. 2015; 21 (42): 12003–12021. https://doi.org/10.3748/wjg.v21.i42.12003

26. Lee J.M., Wong C.M., Ng I.O. Hepatitis B virus-associated multistep hepatocarcinogenesis: A stepwise increase in allelic alterations. Cancer Res. 2008; 68 (14): 5988–5996. https://doi.org/10.1158/0008-5472.CAN-08-0905

27. Toh S.T., Jin Y., Liu L., Wang J., Babrzadeh F., Gharizadeh B., Ronaghi M., Toh H.C., Chow P.K., Chung A.Y., Ooi L.L., Lee C.G. Deep sequencing of the hepatitis B virus in hepatocellular carcinoma patients reveals enriched integration events, structural alterations and sequence variations. Carcinogenesis. 2013; 34 (4): 787–798. https://doi.org/10.1093/carcin/bgs406

28. Friedman S.L. Mechanisms of hepatic fibrogenesis. Gastroenterology. 2008; 134 (6): 1655–1669. https://doi.org/10.1053/j.gastro.2008.03.003.

29. Reig M., Mariño Z., Perelló C., Iñarrairaegui M., Ribeiro A., Lens S., Díaz A., Vilana R., Darnell A., Varela M., Sangro B., Calleja J.L., Forns X., Bruix J. Unexpected high rate of early tumor recurrence in patients with HCV-related HCC undergoing interferon-free therapy. J. Hepatol. 2016; 65 (29): 719–726. https://doi.org/10.1016/j.jhep.2016.04.008

30. Camma` C., Bruno S., Di Marco V., Di Bona D., Rumi M., Vinci M., Rebucci C., Cividini A., Pizzolanti G., Minola E., Mondelli M.U., Colombo M., Pinzello G., Craxı A. Insulin resistance is associated with steatosis in nondiabetic patients with genotype 1 chronic hepatitis C. Hepatology. 2007; 43 (5): 64–71. https://doi.org/10.1002/hep.20983

31. Levrero M. Viral hepatitis and liver cancer: the case of hepatitis C. Oncogene. 2006; 25 (10): 3834–3847. https://doi.org/10.1038/sj.onc.1209562

32. Greene F.L., Sobin L.H. The staging of cancer: a retrospective and prospective appraisal. CA. Cancer J. Clin. 2008; 58 (3): 180–190. https://doi.org/10.3322/CA.2008.0001

33. Hsu C.Y., Lee Y.H., Hsia C.Y., Huang Y.H., Su C.W., Lin H.C., Lee R.C., Chiou Y.Y., Lee F.Y., Huo T.I. Performance status in patients with hepatocellular carcinoma: determinants, prognostic impact, and ability to improve the Barcelona Clinic Liver Cancer system. Hepatology. 2013; 57 (1): 112–119. 10.1002/hep.25950. https://doi.org/10.1002/hep.25950

34. Granov A.M., Tarazov P.G., Granov D.A., Polikarpov A.A., Oleshchuk N.V. Successful combination treatment of a patient with recurrent hepatocellular carcinoma. Grekov's Bulletin of Surgery. 2015; 174 (2): 98–100. (In Russian)

35. Kosyrev V.Yu. Modern strategies for staging and treatment of hepatocellular carcinoma in cirrhosis. Practical oncology. 2019; 20 (3): 169–178. https://doi.org/10.31917/2003169 (In Russian)

36. Maltseva A.P., Syutkin V.E., Kolyshev I.Yu., Rudakov V.S., Svetlakova D.S., Sadykhov Z.A., Udalov Yu.D., Voskanyan S.E. Transplantation in oncology: the future of a multidisciplinary approach. Transplantologiya. The Russian Journal of Transplantation. 2019; 11 (3): 218–233. https://doi.org/10.23873/2074-0506-2019-11-3-218-233 (In Russian)

37. Grandhi M.S., Kim A.K., Ronnekleiv-Kelly S.M., Kamel I.R., Ghasebeh M.A., Pawlik T.M. Hepatocellular carcinoma: From diagnosis to treatment. Surg. Oncol. 2016; 25 (2): 74–85. https://doi.org/10.1016/j.suronc.2016.03.002

38. Page A.J.,Cosgrove D.C., Philosophe B., Pawlik T.M. Hepatocellularcarcinoma: diagnosis, management, andprognosis. Surg. Oncol. Clin. N. Am. 2014; 23 (2): 289–311. https://doi.org/10.1016/j.soc.2013.10.006

39. Dolgushin B.I., KosyrevV.Yu., Shishkina N.A. Nine-year Survival Rate after Locoregional Treatment in a Patient with Hepatocellular Carcinoma. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2014; 19 (3): 123–126. (In Russian)

40. Forner A., Reig M., Bruix J. Hepatocellular carcinoma. Lancet. 2018; 391 (10127): 1301–1314. https://doi.org/10.1016/S0140-6736(18)30010-2

41. Zhang D.Y., Friedman S.L. Fibrosis-dependent mechanisms of hepatocarcinogenesis. Hepatology. 2012; 56 (2): 769–775. https://doi.org/10.1002/hep.25670

42. Hartke J., Johnson M., Ghabril M. Thediagnosis and treatment of hepatocellular carcinoma. Semin. Diagn. Pathol. 2017; 34 (2): 153–159. https://doi.org/10.1053/j.semdp.2016.12.011

43. Sapisochin G., Goldaracena N., Laurence J.M., Dib M., Barbas A., Ghanekar A., Cleary S.P., Lilly L., Cattral M.S., Marquez M., Selzner M., Renner E., Selzner N., McGilvray I.D., Greig P.D., Grant D.R. The extended Toronto criteria for liver transplantation in patients with hepatocellular carcinoma: A prospective validation study. Hepatology. 2016; 64 (6): 2077–2088. https://doi.org/10.1002/hep.28643

44. Rhim H., Lim H.K. Radiofrequency ablation of hepatocellular carcinoma: pros and cons. Gut Liver. 2010; 4 (Suppl.1): S113– 118. https://doi.org/10.5009/gnl.2010.4.S1.S113

45. Revishvili A.Sh., Zhao A.V., Ionkin D.A. Kriokhirurgiya [Cryosurgery]. Moscow: GEOTAR-Media, 2019. 376 p. (In Russian)

46. Omata M., Lesmana L.A., Tateishi R., Chen P.-J., Lin S.-M., Yoshida H., Kudo M., Lee J.M., Choi B.I., Poon R.T.P., Shiina S., Cheng A.L., Jia J.-D., Obi S., Han K.H., Jafri W., Chow P., Lim S.G., Chawla Y.K., Budihusodo U., Gani R.A., Lesmana C.R., Putranto T.A., Liaw Y.F., Sarin S.K. Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma. Hepatol. Int. 2010; 4 (1): 439–474. https://doi.org/10.1007/s12072-010-9165-7

47. Adhoute X., Penaranda G., Raoul J., Blanc J., Edeline J., Conroy G., Perrier H., Pol B., Bayle O., Monnet O., Beaurain P., Muller C., Castellani P., Bronowicki J.-P., Bourlière M. Prognosis of advanced hepatocellular carcinoma: a new stratification of Barcelona Clinic Liver Cancer stage C: results from a French multicenter study. Eur. J. Gastroenterol. Hepatol. 2016; 28 (14): 433–440. https://doi.org/10.3748/wjg.v23.i14.2545


Review

For citations:


Vishnevsky V.A., Ayvazyan Kh.A., Ikramov R.Z., Ionkin D.A., Zhavoronkova O.I., Stepanova Yu.A., Varava A.B., Kovalenko Yu.A., Zharikov Yu.O., Goncharov A.B., Olifir A.A., Pakhomova A.Yu., Bugaev S.A., Zhao A.V. Modern principles of hepatocellular carcinoma treatment. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2020;25(2):15-26. (In Russ.) https://doi.org/10.16931/1995-5464.2020215-26

Views: 1025


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1995-5464 (Print)
ISSN 2408-9524 (Online)