الفهرس | Only 14 pages are availabe for public view |
Abstract HCC is a frequent cancer that is among the leading causes of cancer deaths worldwide. Most cases are associated with an underlying liver disease, usually liver cirrhosis. HCC is an important leading cause of death among cirrhotic patients. The treatment of HCC based on various classification system. In Europe and in USA, the most commonly used staging system is the BCLC allocation system, which links prognostic factors, stages and therapeutic proposal. In the staging system, the intermediate stage is defined by by large, unresectable or multinodular HCC in patients with excellent performance status with Child Pugh A or B liver cirrhosis. For these patients the best therapeutic option is transarterial chemoemolization. While the BCLC staging classification recommends sorafenib as the first line therapy for BCLC stage C patients, access to sorafenib is often limited in developing countries, TACE has been recommended and widely used as palliative therapy in China and other Asian countries. Studies detected high survival with TACE in patients with unresectable HCC, compared to supportive care or suboptimal therapies. Radiological response after TACE is assessed through guidelines known as the modified response Evaluation Criteria of Solid Tumors (mRECIST): 1-Complete response (CR): disappearance of any intratumoral arterial enhancement in all target lesions. |