Radiologické destrukční metody hepatocelulárního karcinomu

Title in English Radiological destructive methods of hepatocellular carcinoma


Year of publication 2019
Type Article in Periodical
Magazine / Source Postgraduální gastroenterologie & hepatologie
MU Faculty or unit

Faculty of Medicine

Keywords Hepatocellular carcinoma; transarterial chemoembolisation; radiofrequency ablation; indications; contraindications
Description This work deals with methods of treatment of hepatocellular carcinoma (HCC) by radiological interventional methods. Based on the recommendations of professional societies, the indications, contraindications and possibilities of individual radiological interventional methods in HCC treatment are discussed. Emphasis is placed on transarterial chemoembolization (TACE). Based on EASL recommendations, TACE is indicated in BCLC B (Barcelona Clinic Liver Cancer) in patients in good general condition without metastasis outside the liver. In addition to indications and contraindications, the work also describes the preparation and follow-up of the patient, performance technique, side effects and current situation in the Czech Republic. The most common side effect is so-called postembolization syndrome, which can be alleviated or eliminated by appropriate prophylactic medication. The effect of embolizing particle type on patient survival has not been demonstrated. The work also marginally deals with radioembolization, which is a method applicable to borderline patients between the BCLC stage B and C (eg patients in worse general condition, extensive liver involvement, in thrombosis of portal vein stem). In the early and very early stages, percutaneous ablation (most commonly radiofrequency or microwave ablation) may be indicated as an alternative to surgery or transplantation. In solitary lesions up to 2 cm, percutaneous ablation achieves similar survival results as surgical resection, and is also suitable for patients with comorbidities that could contraindicate surgery. Radiological intervention methods should be indicated on the basis of decision of the tumor board.
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