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Non-surgical treatment of hepatocellular carcinoma. An overview

机译:肝细胞癌的非手术治疗。概述

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Surgery is often not a treatment option in patients with hepatocellular carcinoma with the numerous limitations of liver transplantation or surgical resection due to coexisting cirrhosis in the later case. Non-surgical treatments deal with 3 types of methods: local ablation with curative purpose, transarterial treatments with many technical variants and systemic treatment. Local treatments rely on chemical or thermic agents to achieve ablation of liver lesions, which not exceed initially 3 cm in diameter. The use of radiofrequency ablation allows now larger limits. Intra-arterial treatment usually combines intra-arterial chemotherapy with embolisation of hepatic artery in a procedure called chemoembolisation. Its antitumoral effect mainly due to ischemia is well documented but the influence on survival remains controversial. Finally systemic treatments have yet to be demonstrated useful: new agents and new randomised trials are still needed.
机译:肝细胞癌患者由于并存肝硬化而存在肝移植或手术切除的诸多局限性,因此手术通常不是治疗的选择。非手术治疗涉及三种类型的方法:具有治疗目的的局部消融,具有许多技术变型的经动脉治疗和全身治疗。局部治疗依靠化学或热疗剂消融肝脏损伤,最初直径不超过3 cm。现在使用射频消融允许更大的限制。动脉内治疗通常将动脉内化疗与肝动脉栓塞结合在一起,称为化学栓塞。它的抗肿瘤作用主要是由缺血引起的,已有充分的文献记载,但对生存的影响尚存争议。最终,全身治疗尚未被证明有用:仍然需要新的药物和新的随机试验。

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