Skip to main content
Top
Published in: Annals of Surgical Oncology 4/2008

01-04-2008 | Gastrointestinal Oncology

Treatment of Large and Advanced Hepatocellular Carcinoma

Authors: Eddie K. Abdalla, MD, Alban Denys, MD, Kiyoshi Hasegawa, MD, Thomas W. T. Leung, MD, Masatoshi Makuuchi, MD, PhD, Ravi Murthy, MD, Dario Ribero, MD, Daria Zorzi, MD, Jean-Nicolas Vauthey, MD, Guido Torzilli, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2008

Login to get access

Excerpt

Selection of patients with advanced disease who should undergo aggressive therapy remains controversial. Analysis of outcomes following treatment of appropriately selected patients with advanced HCC, specifically those with large or multiple tumors or major vascular invasion, reveal that significant progress has been achieved in selection for surgery and the indication for systemic chemotherapy and arterial chemoembolization. This article examines current approaches for the surgical treatment of large HCC, multinodular HCC, HCC associated with major vascular invasion, and examines combined approaches for the treatment of advanced HCC. …
Literature
1.
go back to reference Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996; 334:693–9PubMedCrossRef Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996; 334:693–9PubMedCrossRef
2.
go back to reference Lo CM, Ngan H, Tso WK, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 2002; 35:1164–71PubMedCrossRef Lo CM, Ngan H, Tso WK, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 2002; 35:1164–71PubMedCrossRef
3.
go back to reference Llovet JM, Bustamante J, Castells A, et al. Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials. Hepatology 1999; 29:62–7PubMedCrossRef Llovet JM, Bustamante J, Castells A, et al. Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials. Hepatology 1999; 29:62–7PubMedCrossRef
4.
go back to reference Pawlik TM, Delman KA, Vauthey JN, et al. Tumor size predicts vascular invasion and histologic grade: implications for selection of surgical treatment for hepatocellular carcinoma. Liver Transpl 2005; 11:1086–92PubMedCrossRef Pawlik TM, Delman KA, Vauthey JN, et al. Tumor size predicts vascular invasion and histologic grade: implications for selection of surgical treatment for hepatocellular carcinoma. Liver Transpl 2005; 11:1086–92PubMedCrossRef
5.
go back to reference Vauthey JN, Lauwers GY, Esnaola NF, et al. Simplified staging for hepatocellular carcinoma. J Clin Oncol 2002; 20:1527–36PubMedCrossRef Vauthey JN, Lauwers GY, Esnaola NF, et al. Simplified staging for hepatocellular carcinoma. J Clin Oncol 2002; 20:1527–36PubMedCrossRef
6.
go back to reference Jonas S, Bechstein WO, Steinmuller T, et al. Vascular invasion and histopathologic grading determine outcome after liver transplantation for hepatocellular carcinoma in cirrhosis. Hepatology 2001; 33:1080–6PubMedCrossRef Jonas S, Bechstein WO, Steinmuller T, et al. Vascular invasion and histopathologic grading determine outcome after liver transplantation for hepatocellular carcinoma in cirrhosis. Hepatology 2001; 33:1080–6PubMedCrossRef
7.
go back to reference Pawlik TM, Poon RT, Abdalla EK, et al. Critical appraisal of the clinical and pathologic predictors of survival after resection of large hepatocellular carcinoma. Arch Surg 2005; 140:450–7PubMedCrossRef Pawlik TM, Poon RT, Abdalla EK, et al. Critical appraisal of the clinical and pathologic predictors of survival after resection of large hepatocellular carcinoma. Arch Surg 2005; 140:450–7PubMedCrossRef
8.
go back to reference Liu CL, Fan ST, Cheung ST, et al. Anterior approach versus conventional approach right hepatic resection for large hepatocellular carcinoma: a prospective randomized controlled study. Ann Surg 2006; 244:194–203PubMedCrossRef Liu CL, Fan ST, Cheung ST, et al. Anterior approach versus conventional approach right hepatic resection for large hepatocellular carcinoma: a prospective randomized controlled study. Ann Surg 2006; 244:194–203PubMedCrossRef
9.
go back to reference Belghiti J, Guevara OA, Noun R, et al. Liver hanging maneuver: a safe approach to right hepatectomy without liver mobilization. J Am Coll Surg 2001; 193:109–11PubMedCrossRef Belghiti J, Guevara OA, Noun R, et al. Liver hanging maneuver: a safe approach to right hepatectomy without liver mobilization. J Am Coll Surg 2001; 193:109–11PubMedCrossRef
10.
go back to reference Ogata S, Belghiti J, Varma D, et al. Two hundred liver hanging maneuvers for major hepatectomy: a single-center experience. Ann Surg 2007; 245:31–5PubMedCrossRef Ogata S, Belghiti J, Varma D, et al. Two hundred liver hanging maneuvers for major hepatectomy: a single-center experience. Ann Surg 2007; 245:31–5PubMedCrossRef
11.
go back to reference Yoshioka H, Sato M, Sonomura T, et al. Factors associated with survival exceeding 5 years after transcatheter arterial embolization for hepatocellular carcinoma. Semin Oncol 1997; 24:S6–29–S26–37 Yoshioka H, Sato M, Sonomura T, et al. Factors associated with survival exceeding 5 years after transcatheter arterial embolization for hepatocellular carcinoma. Semin Oncol 1997; 24:S6–29–S26–37
12.
go back to reference O’Suilleabhain CB, Poon RT, Yong JL, et al. Factors predictive of 5-year survival after transarterial chemoembolization for inoperable hepatocellular carcinoma. Br J Surg 2003; 90:325–31PubMedCrossRef O’Suilleabhain CB, Poon RT, Yong JL, et al. Factors predictive of 5-year survival after transarterial chemoembolization for inoperable hepatocellular carcinoma. Br J Surg 2003; 90:325–31PubMedCrossRef
13.
go back to reference Molmenti EP, Klintmalm GB. Liver transplantation in association with hepatocellular carcinoma: an update of the International Tumor Registry. Liver Transpl 2002; 8:736–48PubMedCrossRef Molmenti EP, Klintmalm GB. Liver transplantation in association with hepatocellular carcinoma: an update of the International Tumor Registry. Liver Transpl 2002; 8:736–48PubMedCrossRef
14.
go back to reference Figueras J, Jaurrieta E, Valls C, et al. Survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma: a comparative study. Hepatology 1997; 25:1485–89PubMedCrossRef Figueras J, Jaurrieta E, Valls C, et al. Survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma: a comparative study. Hepatology 1997; 25:1485–89PubMedCrossRef
15.
go back to reference Hemming AW, Cattral MS, Reed AI, et al. Liver transplantation for hepatocellular carcinoma. Ann Surg 2001; 233:652–9PubMedCrossRef Hemming AW, Cattral MS, Reed AI, et al. Liver transplantation for hepatocellular carcinoma. Ann Surg 2001; 233:652–9PubMedCrossRef
16.
go back to reference Yoo HY, Patt CH, Geschwind JF, Thuluvath PJ. The outcome of liver transplantation in patients with hepatocellular carcinoma in the United States between 1988 and 2001: 5-year survival has improved significantly with time. J Clin Oncol 2003; 21:4329–35PubMedCrossRef Yoo HY, Patt CH, Geschwind JF, Thuluvath PJ. The outcome of liver transplantation in patients with hepatocellular carcinoma in the United States between 1988 and 2001: 5-year survival has improved significantly with time. J Clin Oncol 2003; 21:4329–35PubMedCrossRef
17.
go back to reference Yamamoto J, Iwatsuki S, Kosuge T, et al. Should hepatomas be treated with hepatic resection or transplantation? Cancer 1999; 86:1151–58PubMedCrossRef Yamamoto J, Iwatsuki S, Kosuge T, et al. Should hepatomas be treated with hepatic resection or transplantation? Cancer 1999; 86:1151–58PubMedCrossRef
18.
go back to reference Llovet JM, Fuster J, Bruix J. The Barcelona approach: diagnosis, staging, and treatment of hepatocellular carcinoma. Liver Transpl 2004; 10:S115–20PubMedCrossRef Llovet JM, Fuster J, Bruix J. The Barcelona approach: diagnosis, staging, and treatment of hepatocellular carcinoma. Liver Transpl 2004; 10:S115–20PubMedCrossRef
19.
go back to reference Nagasue N, Kohno H, Chang YC, et al. Liver resection for hepatocellular carcinoma. Results of 229 consecutive patients during 11 years. Ann Surg 1993; 217:375–84PubMedCrossRef Nagasue N, Kohno H, Chang YC, et al. Liver resection for hepatocellular carcinoma. Results of 229 consecutive patients during 11 years. Ann Surg 1993; 217:375–84PubMedCrossRef
20.
go back to reference Poon RT, Fan ST. Evaluation of the new AJCC/UICC staging system for hepatocellular carcinoma after hepatic resection in Chinese patients. Surg Oncol Clin North Am 2003; 12:35–50, viiiCrossRef Poon RT, Fan ST. Evaluation of the new AJCC/UICC staging system for hepatocellular carcinoma after hepatic resection in Chinese patients. Surg Oncol Clin North Am 2003; 12:35–50, viiiCrossRef
21.
go back to reference Vauthey JN, Klimstra D, Franceschi D, et al. Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma. Am J Surg 1995; 169:28–34PubMedCrossRef Vauthey JN, Klimstra D, Franceschi D, et al. Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma. Am J Surg 1995; 169:28–34PubMedCrossRef
22.
go back to reference Ng KK, Vauthey JN, Pawlik TM, et al. Is hepatic resection for large or multinodular hepatocellular carcinoma justified? Results from a multi-institutional database. Ann Surg Oncol 2005; 12:364–73PubMedCrossRef Ng KK, Vauthey JN, Pawlik TM, et al. Is hepatic resection for large or multinodular hepatocellular carcinoma justified? Results from a multi-institutional database. Ann Surg Oncol 2005; 12:364–73PubMedCrossRef
23.
go back to reference Nakashima T, Kojiro M. Pathologic characteristics of hepatocellular carcinoma. Semin Liver Dis 1986; 6:259–66PubMedCrossRef Nakashima T, Kojiro M. Pathologic characteristics of hepatocellular carcinoma. Semin Liver Dis 1986; 6:259–66PubMedCrossRef
24.
go back to reference Minagawa M, Makuuchi M, Takayama T, et al. Selection criteria for hepatectomy in patients with hepatocellular carcinoma and portal vein tumor thrombus. Ann Surg 2001; 233:379–84PubMedCrossRef Minagawa M, Makuuchi M, Takayama T, et al. Selection criteria for hepatectomy in patients with hepatocellular carcinoma and portal vein tumor thrombus. Ann Surg 2001; 233:379–84PubMedCrossRef
25.
go back to reference Groupe d’Etude et de Traitement du Carcinome Hepatocellulaire. A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. N Engl J Med 1995; 332:1256–61CrossRef Groupe d’Etude et de Traitement du Carcinome Hepatocellulaire. A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma. N Engl J Med 1995; 332:1256–61CrossRef
26.
go back to reference Llovet JM, Real MI, Montana X, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 2002; 359:1734–9PubMedCrossRef Llovet JM, Real MI, Montana X, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 2002; 359:1734–9PubMedCrossRef
27.
go back to reference Takayasu K, Arii S, Ikai I, et al. Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology 2006; 131:461–9PubMedCrossRef Takayasu K, Arii S, Ikai I, et al. Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology 2006; 131:461–9PubMedCrossRef
28.
go back to reference Lladó L, Virgili J, Figueras J, et al. A prognostic index of the survival of patients with unresectable hepatocellular carcinoma after transcatheter arterial chemoembolization. Cancer 2000; 88:50–7PubMedCrossRef Lladó L, Virgili J, Figueras J, et al. A prognostic index of the survival of patients with unresectable hepatocellular carcinoma after transcatheter arterial chemoembolization. Cancer 2000; 88:50–7PubMedCrossRef
29.
go back to reference Pacella CM, Bizzarri G, Cecconi P, et al. Hepatocellular carcinoma: long-term results of combined treatment with laser thermal ablation and transcatheter arterial chemoembolization. Radiology 2001; 219:669–78PubMed Pacella CM, Bizzarri G, Cecconi P, et al. Hepatocellular carcinoma: long-term results of combined treatment with laser thermal ablation and transcatheter arterial chemoembolization. Radiology 2001; 219:669–78PubMed
30.
go back to reference Veltri A, Moretto P, Doriguzzi A, et al. Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC). Eur Radiol 2006; 16:661–9PubMedCrossRef Veltri A, Moretto P, Doriguzzi A, et al. Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC). Eur Radiol 2006; 16:661–9PubMedCrossRef
31.
go back to reference Wu F, Wang ZB, Chen WZ, et al. Advanced hepatocellular carcinoma: treatment with high-intensity focused ultrasound ablation combined with transcatheter arterial embolization. Radiology 2005; 235:659–67PubMedCrossRef Wu F, Wang ZB, Chen WZ, et al. Advanced hepatocellular carcinoma: treatment with high-intensity focused ultrasound ablation combined with transcatheter arterial embolization. Radiology 2005; 235:659–67PubMedCrossRef
32.
go back to reference Raoul JL, Guyader D, Bretagne JF, et al. Randomized controlled trial for hepatocellular carcinoma with portal vein thrombosis: intra-arterial iodine–131-iodized oil versus medical support. J Nucl Med 1994; 35:1782–7PubMed Raoul JL, Guyader D, Bretagne JF, et al. Randomized controlled trial for hepatocellular carcinoma with portal vein thrombosis: intra-arterial iodine–131-iodized oil versus medical support. J Nucl Med 1994; 35:1782–7PubMed
33.
go back to reference Uraki J, Yamakado K, Nakatsuka A, Takeda K. Transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma invading the portal veins: therapeutic effects and prognostic factors. Eur J Radiol 2004; 51:12–8PubMedCrossRef Uraki J, Yamakado K, Nakatsuka A, Takeda K. Transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma invading the portal veins: therapeutic effects and prognostic factors. Eur J Radiol 2004; 51:12–8PubMedCrossRef
34.
go back to reference Obi S, Yoshida H, Toune R, et al. Combination therapy of intraarterial 5-fluorouracil and systemic interferon-alpha for advanced hepatocellular carcinoma with portal venous invasion. Cancer 2006; 106:1990–7PubMedCrossRef Obi S, Yoshida H, Toune R, et al. Combination therapy of intraarterial 5-fluorouracil and systemic interferon-alpha for advanced hepatocellular carcinoma with portal venous invasion. Cancer 2006; 106:1990–7PubMedCrossRef
35.
go back to reference Houle S, Yip TK, Shepherd FA, et al. Hepatocellular carcinoma: pilot trial of treatment with Y-90 microspheres. Radiology 1989; 172:857–60PubMed Houle S, Yip TK, Shepherd FA, et al. Hepatocellular carcinoma: pilot trial of treatment with Y-90 microspheres. Radiology 1989; 172:857–60PubMed
36.
go back to reference Shepherd FA, Rotstein LE, Houle S, et al. A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma. Cancer 1992; 70:2250–4PubMedCrossRef Shepherd FA, Rotstein LE, Houle S, et al. A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma. Cancer 1992; 70:2250–4PubMedCrossRef
37.
go back to reference Andrews JC, Walker SC, Ackermann RJ, et al. Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up. J Nucl Med 1994; 35:1637–44PubMed Andrews JC, Walker SC, Ackermann RJ, et al. Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up. J Nucl Med 1994; 35:1637–44PubMed
38.
go back to reference Dancey JE, Shepherd FA, Paul K, et al. Treatment of nonresectable hepatocellular carcinoma with intrahepatic 90Y-microspheres. J Nucl Med 2000; 41:1673–81PubMed Dancey JE, Shepherd FA, Paul K, et al. Treatment of nonresectable hepatocellular carcinoma with intrahepatic 90Y-microspheres. J Nucl Med 2000; 41:1673–81PubMed
39.
go back to reference Lau WY, Leung WT, Ho S, et al. Treatment of inoperable hepatocellular carcinoma with intrahepatic arterial yttrium-90 microspheres: a phase I and II study. Br J Cancer 1994; 70:994–9PubMed Lau WY, Leung WT, Ho S, et al. Treatment of inoperable hepatocellular carcinoma with intrahepatic arterial yttrium-90 microspheres: a phase I and II study. Br J Cancer 1994; 70:994–9PubMed
40.
go back to reference Lau WY, Ho S, Leung TW, et al. Selective internal radiation therapy for nonresectable hepatocellular carcinoma with intraarterial infusion of 90yttrium microspheres. Int J Radiat Oncol Biol Phys 1998; 40:583–92PubMed Lau WY, Ho S, Leung TW, et al. Selective internal radiation therapy for nonresectable hepatocellular carcinoma with intraarterial infusion of 90yttrium microspheres. Int J Radiat Oncol Biol Phys 1998; 40:583–92PubMed
41.
go back to reference Carr BI. Hepatic arterial 90 yttrium glass microspheres (Therasphere) for unresectable hepatocellular carcinoma: interim safety and survival data on 65 patients. Liver Transpl 2004; 10:S107–10PubMedCrossRef Carr BI. Hepatic arterial 90 yttrium glass microspheres (Therasphere) for unresectable hepatocellular carcinoma: interim safety and survival data on 65 patients. Liver Transpl 2004; 10:S107–10PubMedCrossRef
42.
go back to reference Geschwind JF, Salem R, Carr BI, et al. Yttrium-90 microspheres for the treatment of hepatocellular carcinoma. Gastroenterology 2004; 127:S194–205PubMedCrossRef Geschwind JF, Salem R, Carr BI, et al. Yttrium-90 microspheres for the treatment of hepatocellular carcinoma. Gastroenterology 2004; 127:S194–205PubMedCrossRef
43.
go back to reference Lau WY, Ho S, Leung WT, et al. What determines survival duration in hepatocellular carcinoma treated with intraarterial Yttrium-90 microspheres? Hepatogastroenterology 2001; 48:338–40PubMed Lau WY, Ho S, Leung WT, et al. What determines survival duration in hepatocellular carcinoma treated with intraarterial Yttrium-90 microspheres? Hepatogastroenterology 2001; 48:338–40PubMed
44.
go back to reference Goin JE, Salem R, Carr BI, et al. Treatment of unresectable hepatocellular carcinoma with intrahepatic yttrium 90 microspheres: factors associated with liver toxicities. J Vasc Interv Radiol 2005; 16:205–13PubMed Goin JE, Salem R, Carr BI, et al. Treatment of unresectable hepatocellular carcinoma with intrahepatic yttrium 90 microspheres: factors associated with liver toxicities. J Vasc Interv Radiol 2005; 16:205–13PubMed
45.
go back to reference Salem R, Lewandowski RJ, Atassi B, et al. Treatment of unresectable hepatocellular carcinoma with use of 90Y microspheres (TheraSphere): safety, tumor response, and survival. J Vasc Interv Radiol 2005; 16:1627–39PubMed Salem R, Lewandowski RJ, Atassi B, et al. Treatment of unresectable hepatocellular carcinoma with use of 90Y microspheres (TheraSphere): safety, tumor response, and survival. J Vasc Interv Radiol 2005; 16:1627–39PubMed
46.
go back to reference Goin J, Roberts C. Comparison of post-embolization syndrome in the treatment of patients with unresectable hepatocellular carcinoma: Trans-catheter arterial chemo-embolization versus yttrium-90 glass microspheres. World J Nuc Med 2004; 49–56 Goin J, Roberts C. Comparison of post-embolization syndrome in the treatment of patients with unresectable hepatocellular carcinoma: Trans-catheter arterial chemo-embolization versus yttrium-90 glass microspheres. World J Nuc Med 2004; 49–56
47.
48.
go back to reference Yeo W, Mok TS, Zee B, et al. A randomized phase III study of doxorubicin versus cisplatin/interferon alpha-2b/doxorubicin/fluorouracil (PIAF) combination chemotherapy for unresectable hepatocellular carcinoma. J Natl Cancer Inst 2005; 97:1532–8PubMedCrossRef Yeo W, Mok TS, Zee B, et al. A randomized phase III study of doxorubicin versus cisplatin/interferon alpha-2b/doxorubicin/fluorouracil (PIAF) combination chemotherapy for unresectable hepatocellular carcinoma. J Natl Cancer Inst 2005; 97:1532–8PubMedCrossRef
49.
go back to reference Lau WY, Leung TW, Lai BS, et al. Preoperative systemic chemoimmunotherapy and sequential resection for unresectable hepatocellular carcinoma. Ann Surg 2001; 233:236–41PubMedCrossRef Lau WY, Leung TW, Lai BS, et al. Preoperative systemic chemoimmunotherapy and sequential resection for unresectable hepatocellular carcinoma. Ann Surg 2001; 233:236–41PubMedCrossRef
50.
go back to reference Leung TW, Tang AM, Zee B, et al. Factors predicting response and survival in 149 patients with unresectable hepatocellular carcinoma treated by combination cisplatin, interferon-alpha, doxorubicin and 5-fluorouracil chemotherapy. Cancer 2002; 94:421–7PubMedCrossRef Leung TW, Tang AM, Zee B, et al. Factors predicting response and survival in 149 patients with unresectable hepatocellular carcinoma treated by combination cisplatin, interferon-alpha, doxorubicin and 5-fluorouracil chemotherapy. Cancer 2002; 94:421–7PubMedCrossRef
51.
go back to reference Llovet J, Ricci S, Mazzaferro V, et al. Sorafenib improves survival in advanced hepatocellular carcinoma (HCC): Results of a phase III randomized placebo-controlled trial (SHARP trial). J Clin Oncol 2007; 25:LBA1 Llovet J, Ricci S, Mazzaferro V, et al. Sorafenib improves survival in advanced hepatocellular carcinoma (HCC): Results of a phase III randomized placebo-controlled trial (SHARP trial). J Clin Oncol 2007; 25:LBA1
52.
go back to reference Abou-Alfa GK, Schwartz L, Ricci S, et al. Phase II study of sorafenib in patients with advanced hepatocellular carcinoma. J Clin Oncol 2006; 24:4293–300PubMedCrossRef Abou-Alfa GK, Schwartz L, Ricci S, et al. Phase II study of sorafenib in patients with advanced hepatocellular carcinoma. J Clin Oncol 2006; 24:4293–300PubMedCrossRef
Metadata
Title
Treatment of Large and Advanced Hepatocellular Carcinoma
Authors
Eddie K. Abdalla, MD
Alban Denys, MD
Kiyoshi Hasegawa, MD
Thomas W. T. Leung, MD
Masatoshi Makuuchi, MD, PhD
Ravi Murthy, MD
Dario Ribero, MD
Daria Zorzi, MD
Jean-Nicolas Vauthey, MD
Guido Torzilli, MD, PhD
Publication date
01-04-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 4/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-007-9727-7

Other articles of this Issue 4/2008

Annals of Surgical Oncology 4/2008 Go to the issue

Hepatic and Pancreatic Tumors

Biology of Hepatocellular Carcinoma