Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview

The high mortality rate associated with hepatocellular carcinoma (HCC) is partly due to the high proportion of patients who present with advanced stage disease at diagnosis, for whom there are limited treatment options. For selected patients with initially unresectable HCC, locoregional and/or syste...

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Autores principales: Hui-Chuan Sun, Xiao-Dong Zhu
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Publicado: Frontiers Media S.A. 2021
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Acceso en línea:https://doaj.org/article/c197caccee3141ceb94e64c53f8d2640
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spelling oai:doaj.org-article:c197caccee3141ceb94e64c53f8d26402021-11-18T04:57:30ZDownstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview2234-943X10.3389/fonc.2021.772195https://doaj.org/article/c197caccee3141ceb94e64c53f8d26402021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.772195/fullhttps://doaj.org/toc/2234-943XThe high mortality rate associated with hepatocellular carcinoma (HCC) is partly due to the high proportion of patients who present with advanced stage disease at diagnosis, for whom there are limited treatment options. For selected patients with initially unresectable HCC, locoregional and/or systemic treatments can result in tumor downstaging and consequently provide opportunities for surgical intervention and the potential for long-term survival. Therefore, the key aim of ‘conversion therapy’ is to reduce tumor burden so that patients become amenable to surgical resection. Various therapies have been investigated as candidates for downstaging patients with potentially resectable HCC including transarterial chemoembolization, transarterial radioembolization with yttrium-90 microspheres, radiotherapy, systemic therapies and combination or multimodality treatment approaches. However, downstaging conversion therapy remains controversial and there are several challenges such as defining the criteria used to identify the population of patients who are ‘potentially resectable’, the criteria used to define successful downstaging, and the optimum treatment approach to maximize the success of downstaging therapy. In this review article, we summarize clinical experience and evidence of downstaging conversion treatment in patients identified as having ‘potentially resectable’ HCC.Hui-Chuan SunXiao-Dong ZhuFrontiers Media S.A.articlehepatocellular carcinomadownstagingconversion therapyinitial unresectablesystemicNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution DOAJ
collection DOAJ
language EN
topic hepatocellular carcinoma
downstaging
conversion therapy
initial unresectable
systemic
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
spellingShingle hepatocellular carcinoma
downstaging
conversion therapy
initial unresectable
systemic
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Hui-Chuan Sun
Xiao-Dong Zhu
Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview
description The high mortality rate associated with hepatocellular carcinoma (HCC) is partly due to the high proportion of patients who present with advanced stage disease at diagnosis, for whom there are limited treatment options. For selected patients with initially unresectable HCC, locoregional and/or systemic treatments can result in tumor downstaging and consequently provide opportunities for surgical intervention and the potential for long-term survival. Therefore, the key aim of ‘conversion therapy’ is to reduce tumor burden so that patients become amenable to surgical resection. Various therapies have been investigated as candidates for downstaging patients with potentially resectable HCC including transarterial chemoembolization, transarterial radioembolization with yttrium-90 microspheres, radiotherapy, systemic therapies and combination or multimodality treatment approaches. However, downstaging conversion therapy remains controversial and there are several challenges such as defining the criteria used to identify the population of patients who are ‘potentially resectable’, the criteria used to define successful downstaging, and the optimum treatment approach to maximize the success of downstaging therapy. In this review article, we summarize clinical experience and evidence of downstaging conversion treatment in patients identified as having ‘potentially resectable’ HCC.
format article
author Hui-Chuan Sun
Xiao-Dong Zhu
author_facet Hui-Chuan Sun
Xiao-Dong Zhu
author_sort Hui-Chuan Sun
title Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview
title_short Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview
title_full Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview
title_fullStr Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview
title_full_unstemmed Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview
title_sort downstaging conversion therapy in patients with initially unresectable advanced hepatocellular carcinoma: an overview
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/c197caccee3141ceb94e64c53f8d2640
work_keys_str_mv AT huichuansun downstagingconversiontherapyinpatientswithinitiallyunresectableadvancedhepatocellularcarcinomaanoverview
AT xiaodongzhu downstagingconversiontherapyinpatientswithinitiallyunresectableadvancedhepatocellularcarcinomaanoverview
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