Management of Recurrent Hepatocellular Carcinoma
Summary
The management of recurrent hepatocellular carcinoma (HCC) demands a tailored, multidisciplinary approach that balances tumour burden, hepatic reserve and patient fitness. Curative options include repeat hepatectomy in selected patients with sufficient remnant liver function, salvage liver transplantation where organ availability and eligibility criteria permit, and loco-regional ablation such as radiofrequency ablation or microwave ablation for small, accessible lesions. Advances in systemic therapy—encompassing tyrosine kinase inhibitors and immune checkpoint inhibitors—have expanded treatment algorithms for those with multifocal or extrahepatic disease. Optimal outcomes hinge on vigilant surveillance, accurate restaging and personalised decision-making within a specialist hepatobiliary network.
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Management of Recurrent Hepatocellular Carcinoma publication trend
The graph below shows the total number of articles in management of recurrent hepatocellular carcinoma across all publications each year (not limited to Nature Index journals).
Technical terms
Hepatectomy: Surgical resection of part of the liver, either primary or repeat, to remove malignant tissue.
Radiofrequency ablation (RFA): Minimally invasive procedure using thermal energy to induce coagulative necrosis of tumour cells.
Salvage liver transplantation: Transplantation performed after initial curative treatment when HCC recurs, subject to selection criteria.
Overall survival: Interval from treatment until death from any cause, reflecting treatment efficacy.
Disease-free survival: Duration from treatment to the detection of tumour recurrence, indicating remission durability.
Milan criteria: Established guidelines for transplant eligibility, limiting tumour number and size to optimise outcomes.
References
- Surgical Strategies for Recurrent Hepatocellular Carcinoma after Resection: A Review of Current Evidence. Cancers (2023).
- Liver resection versus radiofrequency ablation for recurrent hepatocellular carcinoma: a systematic review and meta-analysis. International Journal of Hyperthermia (2021).
- The role of re-resection in recurrent hepatocellular carcinoma. Langenbeck's Archives of Surgery (2022).
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