Most cases of hepatocellular carcinoma (HCC) occur in the Asia-Pacific region and in patients
with underlying hepatitis B and C viral infection. Although surgical resection is the gold
standard for treatment of HCC, only a few patients are surgical candidates because of their
lack of hepatic reserve. Liver transplantation, which eradicates HCC and replaces damaged
noncancerous hepatic parenchyma, is regarded as the best treatment for HCC in patients
with decompensated liver cirrhosis. However, the shortage of donors limit its widespread
use. Furthermore, the long waiting time for liver transplantation allow for tumor progression
and reduce patient survival. Given this long wait, there is a reasonable clinical need in the
meantime for minimally invasive methods to avoid progression of HCC in patients with
decompensated liver cirrhosis. We herein offer our experiences of therapeutic efficacy and
complications of the procedure and the changes in liver function before and after TACE and
radiofrequency ablation in patients with HCC and decompensated liver cirrhosis, defined as a
Child-Pugh-Turcotte score above 7. (J Liver Cancer 2014;14:139-142)
Treatment of hepatocellular carcinoma is often very challenging when the underlying liver
function is decompensated. Recent experimental and clinical studies showed that some
chelating agents, including deferoxamine, display anti-proliferative actions against tumor
cells, thereby exhibiting anti-cancer effect in certain cancers, including hepatocellular
carcinoma. Based on previous studies, we herein offer our experience of positive tumor
marker response after intra-arterial deferoxamine infusion in a patient presenting with
advanced hepatocellular carcinoma with decompensated hepatic function. Validation of
the efficacy of intra-arterial deferoxamine therapy in the setting of advanced hepatocellular
carcinoma with underlying decompensated hepatic function is warranted. (J Liver Cancer
2014;14:127-130)