Karachaliou GS, Dimitrokallis N, Moris DP. Downstaging strategies for unresectable hepatocellular carcinoma. World J Gastroenterol 2024; 30(20): 2731-2733 [PMID: 38855157 DOI: 10.3748/wjg.v30.i20.2731]
Corresponding Author of This Article
Dimitrios P Moris, MD, MSc, PhD, Surgeon, Department of Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710, United States. dimmoris@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 28, 2024; 30(20): 2731-2733 Published online May 28, 2024. doi: 10.3748/wjg.v30.i20.2731
Downstaging strategies for unresectable hepatocellular carcinoma
Georgia Sofia Karachaliou, Nikolaos Dimitrokallis, Dimitrios P Moris
Georgia Sofia Karachaliou, Division of Gastroenterology, Department of Medicine, Duke University Medical Center, Durham, NC 27710, United States
Nikolaos Dimitrokallis, First Department of Surgery & Organ Transplant Unit, Evangelismos General Hospital, Athens 10676, Greece
Dimitrios P Moris, Department of Surgery, Duke University Medical Center, Durham, NC 27710, United States
Author contributions: Karachaliou GS and Moris DP designed the research study; Dimitrokallis N and Moris DP performed the research; Karachaliou GS and Moris DP analyzed the data and wrote the manuscript; and all authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitrios P Moris, MD, MSc, PhD, Surgeon, Department of Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710, United States. dimmoris@yahoo.com
Received: January 26, 2024 Revised: April 7, 2024 Accepted: April 30, 2024 Published online: May 28, 2024 Processing time: 121 Days and 16.3 Hours
Abstract
A significant number of patients with hepatocellular carcinoma (HCC) are usually diagnosed in advanced stages, that leads to inability to achieve cure. Palliative options are focusing on downstaging a locally advanced disease. It is well-supported in the literature that patients with HCC who undergo successful conversion therapy followed by curative-intent surgery may achieve a significant survival benefit compared to those who receive chemotherapy alone or those who are successfully downstaged with conversion therapy but not treated with surgery. Hepatic artery infusion chemotherapy can be a potential downstaging strategy, since recent studies have demonstrated excellent outcomes in patients with colorectal liver metastatic disease as well as primary liver malignancies.
Core Tip: Patients with hepatocellular carcinoma who undergo successful conversion therapy followed by curative-intent surgery may achieve a significant survival benefit compared to those who receive chemotherapy only without surgery. Hepatic artery infusion chemotherapy can be a potential downstaging strategy, since recent studies have demonstrated excellent outcomes in patients with colorectal liver metastatic disease as well as primary liver malignancies.
