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Updates and advancements in the management of hepatocellular carcinoma patients after hepatectomy
Shi-Dong Lu, Lin Li, Xin-Min Liang, Wu Chen, Fu-Li Chen, Lang-Lin Fan, show all
Received 12 Jul 2019, Accepted 21 Oct 2019, Accepted author version posted online: 25 Oct 2019, Published online: 30 Oct 2019
Download citation https://doi.org/10.1080/17474124.2019.1684898 CrossMark Logo CrossMark
ABSTRACT
Introduction: The 5-year recurrence rate of hepatocellular carcinoma (HCC) after hepatic resection or local ablation is up to 70%. Adjuvant therapies to prevent HCC recurrence have been reported but are not currently recommended by EASL or AASLD guidelines. From randomized controlled trials, meta-analyses and systematic reviews on the safety and efficacy of adjuvant therapies and chemotherapies in HCC patients after resection or local ablation.
Areas covered: PubMed was searched through 15 June 2019. Available evidence was assessed based on the GRADE system.
Expert commentary: Transarterial chemoembolization is the best adjuvant therapy for HCC patients at high risk of recurrence, antiviral therapy with nucleoside analogs is effective for preventing recurrence of HBV-related HCC, and interferon-α is effective for preventing recurrence of HCV-related HCC. Further studies are needed to clarify the efficacy of adjuvant immune checkpoint inhibitors. Adjuvant sorafenib appears to offer negligible clinical benefit and high risk of adverse effects.
KEYWORDS: Adjuvant, hepatocellular carcinoma, hepatic resection, tumor recurrence
Additional information
Funding
This work was supported by the Graduate Course Construction Project of Guangxi Medical University (YJSA2017014), the Foundation Ability Enhancement Project for Young Teachers in Guangxi Universities (2018KY0122), the Guangxi Natural Science Foundation (2018GXNSFBA138018), and 'Guangxi BaGui Scholars' Special Fund .
Article highlights
Postoperative nucleoside analog therapy is safe and effective to prevent recurrence in patients with HBV-related HCC in Asian.
Postoperative adjuvant interferon-α is safe and effective to prevent recurrence in patients with HCV-infected HCC.
Postoperative adjuvant TACE is safe and effective to prevent recurrence in patients at high risk of recurrence in Asian.
Adjuvant adoptive immunotherapy is safe and effective to prevent HCC recurrence after surgery.
Adjuvant sorafenib is not an effective therapy to prevent HCC recurrence after surgery. |
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