Hepatozelluläres Karzinom

Das hepatozelluläre Karzinom gehört zu den weltweit häufigsten malignen Tumorerkrankungen. Nur bei einer frühzeitigen Diagnose ist eine kurative Therapie möglich. Trotz etablierter Vorsorgeuntersuchungen werden die meisten Patienten erst im fortgeschrittenen Stadium diagnostiziert und das relative 5-Jahres-Überleben in Deutschland liegt bei nur 15 %. Die systemische Therapie stellt eine wichtige Therapieoption dar. Mit der Zulassung der Immuntherapie hat kürzlich ein Paradigmenwechsel in der Therapie des HCC stattgefunden.

Abstract

Hepatocellular carcinoma (HCC) is the fifth most common cause of cancer with an increasing incidence. The major HCC risk factor in 80 % of all patients is liver cirrhosis followed by chronic hepatitis B infection or non-alcoholic steatohepatitis (NASH) in non-cirrhotic HCC patients. In early BCLC stages curative treatment applying liver resection, liver transplantation or local ablation is feasible, but, despite increased usage of surveillance programmes two-thirds of HCC patients are diagnosed in advanced BCLC stages. Transarterial chemoembolization (TACE) and selective internal radiation therapy (SIRT) show improved tumor control in BCLC stage B. In fact, major advances in HCC therapy concern medical treatment with the implementation of immunotherapy. The combination of atezolizumab with bevacizumab comprises the new first-line treatment in BCLC stage C. Tyrosine kinase inhibitors (TKI) are indicated in case of contraindications or as second line therapy.

Schlüsselwörter

hepatozelluläres Karzinom (HCC) - BCLC - transarterielle Chemoembolisation (TACE) - Immuntherapie

Key words

hepatocellular carcinoma (HCC) - BCLC - transarterial chemoembolization (TACE) - immunotherapy

Publikationsverlauf

Artikel online veröffentlicht:
20. Oktober 2021

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