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Update on Embolization Therapies for Hepatocellular Carcinoma

  • Sirish Kishore
  • Tamir Friedman
  • David C. Madoff
Gastrointestinal Cancers (J Meyer, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Gastrointestinal Cancers

Abstract

Purpose of Review

The purpose of the review is to summarize the latest applications for embolotherapy in the management of patients with HCC according to BCLC stage.

Recent Findings

While traditionally reserved for patients with unresectable HCC and stage B disease, there is an important role for embolization therapies in earlier stage patients as an adjunct to ablation, bridging, or downstaging therapy, as a means to improve safety of resection, and potentially as an arterial ablative option in the case of radioembolization. Newer applications of radioembolization such as radiation segmentectomy have the potential to provide cure in localized unifocal disease, and transarterial chemoembolization–portal vein embolization and radiation lobectomy may provide a combination of treatment and future liver remnant hypertrophy for planned hepatic resection. There is also an increasing role for embolization in the treatment of stage C disease, and recent data suggest it can be used in combination with sorafenib with the potential for survival benefit over sorafenib alone, even in the case of portal vein tumor thrombus.

Summary

Embolization therapies play an increasingly important role in patients with BCLC stage A–C hepatocellular carcinoma. While different therapies may be offered on a patient-specific basis, there are limited prospective RCT data to support superiority of one technique over another.

Keywords

Hepatocellular carcinoma Embolotherapy Bland embolization Chemoembolization Radioembolization Locoregional therapy 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors..

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Sirish Kishore
    • 1
  • Tamir Friedman
    • 1
  • David C. Madoff
    • 1
  1. 1.Department of Radiology, Division of Interventional RadiologyNew York Presbyterian Hospital/Weill Cornell Medical CenterNew YorkUSA

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