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Neoadjuvant and adjuvant treatment strategies for hepatocellular carcinoma
Authors:Clifford Akateh  Sylvester M Black  Lanla Conteh  Eric D Miller  Anne Noonan  Eric Elliott  Timothy M Pawlik  Allan Tsung  Jordan M Cloyd
Institution:Department of Surgery;Division of Transplant Surgery;Division of Gastroenterology;Department of Radiation Oncology;Division of Medical Oncology;Division of Diagnostic Radiology;Division of Surgical Oncology
Abstract:Hepatocellular carcinoma(HCC) is the most common liver malignancy worldwide and a major cause of cancer-related mortality for which liver resection is an important curative-intent treatment option. However, many patients present with advanced disease and with underlying chronic liver disease and/or cirrhosis, limiting the proportion of patients who are surgical candidates. In addition, the development of recurrent or de novo cancers following surgical resection is common. These issues have led investigators to evaluate the benefit of neoadjuvant and adjuvant treatment strategies aimed at improving resectability rates and decreasing recurrence rates. While high-level evidence to guide treatment decision making is lacking, recent advances in locoregional and systemic therapies, including antiviral treatment and immunotherapy, raise theprospect of novel approaches that may improve the outcomes of patients with HCC. In this review, we evaluate the evidence for various neoadjuvant and adjuvant therapies and discuss opportunities for future clinical and translational research.
Keywords:Hepatocellular carcinoma  Neoadjuvant therapy  Adjuvant therapy  Neoplasm recurrence  Hepatectomy  Liver cirrhosis
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