| Theme |
Treatment Strategy for Advanced Hepatocellular Carcinoma |
| Title |
Treatment for Advanced Hepatocellular Carcinoma with Extrahepatic Metastasis |
| Author |
Koji Uchino |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author |
Ryosuke Tateishi |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author |
Kazuhiko Koike |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| [ Summary ] |
Despite significant advances in the treatment of intrahepatic lesions, the prognosis of advanced hepatocellular carcinoma (HCC) with extrahepatic metastasis remains poor. Sorafenib is the only treatment proven to have efficacy in RCT for such patients. However, since the efficacy of sorafenib is not completely satisfactory, in real‒world settings, intrahepatic and extrahepatic lesions are frequently treated with multidisciplinary treatments including various loco‒regional procedures. Surgical resection of lung, lymph node, and adrenal grand metastases and radiation therapy for bone, brain, lymph node and adrenal grand metastases have been previously reported as treatment options for extrahepatic metastasis. We have previously reported that controllability of intrahepatic lesions and performance status are important prognostic factors in patients with extrahepatic metastasis. Therefore, patients with intrahepatic lesions under control, good performance status, and preserved liver function are candidates for multidisciplinary treatment. So far, definitive clinical evidence of a survival benefit from multidisciplinary treatment for advanced HCC with extrahepatic metastasis is lacking. Further studies are needed in this area. |