The intention of hepatocellular carcinoma (HCC) surveillance is to detect and treat cancer at early stages which leads to improvement in liver-related survival. Historically, surveillance has been restricted to select patients with well-compensated cirrhosis and decompensated cirrhosis unless candidates for transplant. This chapter reviews the pros and cons of this restriction. Although liver dysfunction can limit HCC treatment and adversely affect overall mortality, there is heterogeneity in prognosis among patients with decompensated cirrhosis. Also, advances in selective delivery of locoregional therapies and systemic therapies may be better tolerated and offer benefit to select patients with CPS class B cirrhosis.

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Should Hepatocellular Carcinoma Surveillance Be Performed Only for Patients with Decompensated Cirrhosis If They Are Listed for Liver Transplantation?

  • Dharani Guttikonda,
  • Sheila Eswaran

摘要

The intention of hepatocellular carcinoma (HCC) surveillance is to detect and treat cancer at early stages which leads to improvement in liver-related survival. Historically, surveillance has been restricted to select patients with well-compensated cirrhosis and decompensated cirrhosis unless candidates for transplant. This chapter reviews the pros and cons of this restriction. Although liver dysfunction can limit HCC treatment and adversely affect overall mortality, there is heterogeneity in prognosis among patients with decompensated cirrhosis. Also, advances in selective delivery of locoregional therapies and systemic therapies may be better tolerated and offer benefit to select patients with CPS class B cirrhosis.