Chirurgische Therapie von Lebertumoren: Resektion vs. Ablation [Surgical therapy of liver tumors: resection vs. ablation].

Details

Serval ID
serval:BIB_4170941FD7BB
Type
Article: article from journal or magazin.
Collection
Publications
Title
Chirurgische Therapie von Lebertumoren: Resektion vs. Ablation [Surgical therapy of liver tumors: resection vs. ablation].
Journal
Praxis
Author(s)
Hübner M., McCormack L., Clavien P.A.
ISSN
1661-8157 (Print)
ISSN-L
1661-8157
Publication state
Published
Issued date
2005
Peer-reviewed
Oui
Volume
94
Number
33
Pages
1255-1259
Language
german
Notes
Publication types: English Abstract ; Journal Article ; ReviewPublication Status: ppublish
Abstract
A few years ago surgical resection was the only treatment modality for primary and metastatic liver tumors. However, most of the liver tumors are diagnosed at advanced stage and are unresectable. Criteria for unresectability are: uncontrolled extrahepatic disease, extensive intrahepatic tumor growth, insufficient remnant liver volume and severe co-morbid disease. Several therapeutic strategies have been developed to deal with primarily unresectable tumors. A downstaging ("downsizing") of hepatocellular carcinoma (HCC) can be reached by transarterial chemoembolisation (TACE) or local tumor ablation using ethanol injection, cryosurgery and radiofrequency. Preoperative unilateral portal vein embolization resulting in hypertrophy of the remnant liver volume permits to resect some patients with former unresectable liver tumors. Furthermore, liver transplantation is an option for patients with early stage HCC and liver cirrhosis. Preoperative downstaging of colorectal metastases can be achieved with neoadjuvant chemotherapy, whereas TACE, ethanol injection and liver transplantation are no established options for these patients. So far, there are no standardized guidelines for the treatment of patients with unresectable primary or metastatic liver tumors. In this review we aim to describe the different approaches suggested in the literature and to present our algorithms for the management of patients with liver tumors.
Keywords
Algorithms, Carcinoma, Hepatocellular/drug therapy, Carcinoma, Hepatocellular/surgery, Chemoembolization, Therapeutic, Chemotherapy, Adjuvant, Colorectal Neoplasms/secondary, Combined Modality Therapy, Humans, Liver Neoplasms/drug therapy, Liver Neoplasms/surgery, Liver Transplantation, Neoadjuvant Therapy
Pubmed
Create date
05/08/2012 12:21
Last modification date
20/08/2019 14:41
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