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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Frontiers Media S.A.
2021
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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) |
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hepatocellular carcinoma downstaging conversion therapy initial unresectable systemic Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 |
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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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