Management of hepatocellular carcinoma (HCC) is challenging due to the complex relationship between underlying liver disease, tumor burden, and liver function. HCC is also notorious for its high recurrence rate even after curative treatment for early-stage tumor. Liver transplantation can substantially alter patient prognosis, but donor availability varies by each patient which further complicates treatment decision. Recent advancements in HCC treatments have introduced numerous potentially efficacious treatment modalities. However, high level evidence comparing the risks and benefits of these options is limited. In this complex situation, multidisciplinary approach or multidisciplinary team care has been suggested as a valuable strategy to help cope with escalating complexity in HCC management. Multidisciplinary approach involves collaboration among medical and health care professionals from various academic disciplines to provide comprehensive care. Although evidence suggests that multidisciplinary care can enhance outcomes of HCC patients, robust data from randomized controlled trials are currently lacking. Moreover, the implementation of a multidisciplinary approach necessitates increased medical resources compared to conventional cancer care. This review summarizes the current evidence on the role of multidisciplinary approach in HCC management and explores potential future directions.
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the fourth most common cancer among men in South Korea, where the prevalence of chronic hepatitis B infection is high in middle and old age. The current practice guidelines will provide useful and sensible advice for the clinical management of patients with HCC. A total of 49 experts in the fields of hepatology, oncology, surgery, radiology, and radiation oncology from the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2018 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions. These guidelines provide useful information and direction for all clinicians, trainees, and researchers in the diagnosis and treatment of HCC.
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Despite recent advances in the treatment of hepatocellular carcinoma (HCC), the prognosis
of patients with extrahepatic metastasis from HCC still remains dismal. The current study
presents a case of HCC that was metastatic to the pelvis and describes successful treatment
with multidisciplinary approach to the skeletal metastasis. The patient was a 67-year-old
male who presented with right pelvic pain 28 months following right hepatectomy for HCC.
Computed tomography and magnetic resonance imaging indicated a solitary bone metastasis
without intrahepatic recurrence. Complete response was achieved with multidisciplinary
management including sorafenib, transarterial embolization, surgery to remove the
metastatic mass and radiotherapy after surgery. A post-operative follow-up 15 months later
found that the patient remained in good health with maintained complete response. This case
suggests that a multidisciplinary approach can achieve long-term cancer-free survival and
prolonged life expectancy beyond palliative care for patients with solitary bone metastasis
after curative surgery for HCC.