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Dr Gish: Hepatocellular Carcinoma - Looking back from 2020: What has happened over the last 2 years?
Hepatocellular carcinoma (HCC) accounts for the majority of primary liver cancers
As of 2018, liver cancers were 4th most common cause of cancer-related death; prior to 2018, liver cancers were 3rd most common cause of cancer-related deaths
The World Health Organization (WHO) estimates that >1 million patients will die from liver cancer in 2030
In the US, the rate of death from liver cancer increased by 43% (from 7.2 to 10.3 deaths per 100,000) between 2000 and 2016
With a 5-year survival of 18%, liver cancer is the second most lethal tumor after pancreatic cancer
HCC Practice Points
•GALAD score is now the state of art for HCC early detection to be used with imaging
•Use LiRADS for scoring observations in liver imaging in cirrhosis patients
•Consider biopsy of all liver tumors that are not resection candidates
•Sorafenib, lenvatiniband atezolizumab+bevacizumab are recommended as first-line therapies for managing unresectable HCC
•Regorafenib, cabozantinib, ramucirumab, lenvatinib, nivolumab,
nivolumab+ipilimumab, sorafenib, and pembrolizumab as second-line
for managing HCC
•Factors to take into account when selecting subsequent-line therapy include prior lines of therapy and AFP levels for ramucirumab
•Single-agent immune checkpoint inhibitors have not met endpoints in phase 3 studies to date; however, ICI combinations are key options
•Strategies incorporating MDT team-based care and shared decision
-making improve outcomes in patients with HCC
•Statins are useful to prevent HCC and in management of HCC
•New Normal AFP 5.5
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发表于 2020-9-13 21:15