E-flat major HCC prognostic systems sh Uchlich are summarized in Table 1. Currently, treatment Sans purchase ABT-737 Tze progress in several aspects of the management of HCC confinement Lich improved treatment of HCV, made 51 53 was reduced incidence of HBV infection after extensive vaccination efforts, 54 56 improved screening and early in HCC patients at high risk in some countries too, 13 in 2007 and approval of the oral cancer drug sorafenib in the treatment of advanced HCC.57, 58 A variety of treatment options for HCC patients, but currently the only curative option is liver transplantation, a small minority of HCC patients benefits. Attributed Given the expected increase in the incidence of HCC due to HCV liver cirrhosis and is associated with obesity, 59 61 associated, it is necessary for the upcoming clinical and translational research in this accelerated disease.
The standard surgical management for early stage HCC consists of resection or liver transplantation. However, initially only 10% to 30% of patients with HCC Highest pr Is presents, then put They surgery.62 In general, h Treatment of HCC depends not only on the extent order Apatinib of the tumor, but also the degree of underlying Leberfunktionsst requirements. Be patient with liver cirrhosis can kill lokoregion candidates for limited surgical resection, liver transplantation is not it Re ablative therapy depends Ngig on the severity of cirrhosis. In patients with no evidence of cirrhosis, liver resection was the mainstay of surgical treatment.
In patients with moderate to severe liver cirrhosis, the transplant a potentially ideal treatment for small groups E, otherwise unresectable HCC because the underlying liver cirrhosis, the risk of liver tumors.63 subsequentnewprimary 65Theideal treatment strategy is removed, but also controversial for small HCC patients with liver cirrhosis and mild resection or transplantation. 66.67 However, due to the limited availability of organ donors and also for the cultural and economic reasons, the surgical resection is the mainstay of therapy for patients with HCC worldwide Descr nkt To the liver. Selection of patients for surgical resection based on several criteria, including the absence of extrahepatic disease, the degree of Funktionsst Tion of the liver and technical considerations, such as the adequacy of the rest of the liver and the future involvement of the large-s base-vascular tumor structures such as the portal vein or vena cava.
Patients with normal liver parenchyma are usually entitled to an extended resection, w While patients with compensated cirrhosis candidates for partial hepatectomy as a major or minor in select F May be cases. Surgery in patients with underlying cirrhosis may be associated with significant morbidity T and mortality.68, 69, although perioperative mortality T can be as high as 30% to 50% in patients who are children Pugh B or C, patients, the Child-Pugh class A had a surgical mortality of only 5% to 10% .70,71 The disease model of end-stage liver go Ren bilirubin, creatinine and international normalized ratio and was shown a simple but accurate method for his prediction of postoperative liver failure and mortality t. The patients had a MELD score of zero mortality 9 in two recent series of important institutional patients after resection HCC.69, 72 In most series,