Yang YQ, Wen ZY, Liu XY, Ma ZH, Liu YE, Cao XY, Hou L, Xie H. Current status and prospect of treatments for recurrent hepatocellular carcinoma. World J Hepatol 2023; 15(2): 129-150 [PMID: 36926237 DOI: 10.4254/wjh.v15.i2.129]
Corresponding Author of This Article
Hui Xie, MD, Chief Doctor, Department of Oncology, Fifth Medical Center of Chinese PLA General Hospital, No. 100 Western 4th Ring Middle Road, Fengtai District, Beijing 100039, China. xh302jr@126.com
Research Domain of This Article
Oncology
Article-Type of This Article
Review
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/
Yu-Qing Yang, Yan-E Liu, Department of Epidemiology and Biostatistics, Jilin University, Changchun 130021, Jilin Province, China
Zhen-Yu Wen, Department of Occupational and Environmental Health, Jilin University, Changchun 130021, Jilin Province, China
Xiao-Yan Liu, Senior Department of Hepatology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
Zhen-Hu Ma, Xue-Ying Cao, Li Hou, Hui Xie, Senior Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
Author contributions: Yang YQ wrote the paper; Wen ZY, Liu XY, Ma ZH, Liu YE, Cao XY, Xie H and Hou L provided ideas and reviewed the 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: Hui Xie, MD, Chief Doctor, Department of Oncology, Fifth Medical Center of Chinese PLA General Hospital, No. 100 Western 4th Ring Middle Road, Fengtai District, Beijing 100039, China. xh302jr@126.com
Received: September 18, 2022 Peer-review started: September 18, 2022 First decision: October 30, 2022 Revised: November 13, 2022 Accepted: January 23, 2023 Article in press: January 23, 2023 Published online: February 27, 2023 Processing time: 159 Days and 3.7 Hours
Abstract
Owing to its heterogeneous and highly aggressive nature, hepatocellular carcinoma (HCC) has a high recurrence rate, which is a non-negligible problem despite the increasing number of available treatment options. Recent clinical trials have attempted to reduce the recurrence and develop innovative treatment options for patients with recurrent HCC. In the event of liver remnant recurrence, the currently available treatment options include repeat hepatectomy, salvage liver transplantation, tumor ablation, transcatheter arterial chemoembolization, stereotactic body radiotherapy, systemic therapies, and combination therapy. In this review, we summarize the strategies to reduce the recurrence of high-risk tumors and aggressive therapies for recurrent HCC. Additionally, we discuss methods to prevent HCC recurrence and prognostic models constructed based on predictors of recurrence to develop an appropriate surveillance program.
Core Tip: The current rate of recurrence after initial hepatocellular carcinoma treatment remains unsatisfactory. Repeat hepatectomy and salvage liver transplantation are the preferred options for patients who meet the criteria. However, for patients whose clinical situation do not allow these treatments, non-surgical treatment can also provide survival benefits. Additionally, adjuvant treatment strategies to prevent recurrence and proper surveillance are effective tools to improve overall patient survival. This review summarizes the existing literature to help guide clinical decision-making and provide directions for further research.
