Abstract
There have been major advances recently on the therapeutic approaches of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Surgical treatments are the key curative treatments of HCC, whereas local ablative treatments may also achieve clinical remission in selected cases. Trans-arterial locoregional therapies are regarded as palliative but still lead to improved survival. There have been major breakthroughs in the systemic therapies for HCC. The first marketed targeted therapy, sorafenib, was shown to improve survival in patients with advanced HCC. Studies on other targeted therapies also showed promising results. Suppressing HBV with effective antiviral treatment would also benefit HCC patients by reducing recurrence and improving liver function.
Highlights
Chronic hepatitis B virus (HBV) infection is the leading cause of cirrhosis and hepatocellular carcinoma (HCC) in Asia [1]
Portal vein embolization (PVE) can be considered in if Future Liver Remnant (FLR) is less than 40% [12,13]
The reported responses rate are 37–90% with a 2-year survival ranged from 43–82% 73 Stereotactic body radiation therapy (SBRT) is regarded as a salvage treatment for unresectable HBV-related HCC patients who failed or contraindicated for Transarterial chemoembolization (TACE) or for patients with huge HCC unsuitable for other local treatment modalities [74,75]
Summary
Chronic hepatitis B virus (HBV) infection is the leading cause of cirrhosis and hepatocellular carcinoma (HCC) in Asia [1]. The burden of HBV-related HCC is believed to be the highest in Eastern Asia, sub-Saharan Africa because of HBV endemicity [2]. HCC is the fifth most common cancer in men (523,000 new cases per year, 7.9% of all cancers) and the seventh in women (226,000 new cases per year, 6.5% of all cancers) [3]. The outcome of patients suffering from HBV-related HCC has been steadily improved over the last two decades because of the expansion and advances in treatment options. The treatments are for the tumor and for the virus. The new therapeutic approaches for HBV-related HCC are reviewed together with the conventional ones in this article. 1- and 3-year overall survival: 87.7% and 62.4% [47] 5- and 10-year overall survival: 25.7% and 9.2% [55]
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