Hepatocellular carcinoma Flashcards Preview

BPT Oncology > Hepatocellular carcinoma > Flashcards

Flashcards in Hepatocellular carcinoma Deck (9)
Loading flashcards...
1
Q

How does it present?

A
Weight loss
Fatigue
RUQ Pain 
Liver failure
Jaundice
2
Q

What are some risk factors?

A
Chronic liver disease 
- Viral, EtOH, autoimmune
Hep B (non-cirrhotic)
Obesity
Type 2 diabetes 
NASH
3
Q

What biomaker is useful?

A

Alpha-fetoprotein

4
Q

What are the Barcelona Clinic Liver Cancer stages?

A

Stage 0 or A: Single tumour, or <3 nodules that are <3cm + preserved liver function + ECOG PS 0

Stage B: Multinodular + preserved liver function + ECOG PS 0

Stage C: Portal invasion, extrahepatic spread + preserved liver function + ECOG PS 1-2

Stage D: End-stage liver function + ECOG 3-4

5
Q

What are loco-regional therapies?

A
Ablation
• Radiofrequency, EtOH, microwave
Transarterial (chemotherapy) embolisation (TACE or TAE)
Stereotactic radiosurgery
Brachytherapy
SIRT (selective internal radiotherapy)

If fit
Surgical resection
Orthotopic liver transplantation

6
Q

What is the management of BCLC stage A + B?

A

Stage A + B: loco-regional (systemic therapy if failure)

7
Q

What is managment of BCLC stage C

A

1st line: Sorafenib or lenvatinib

2nd line: nivolumab or pembro

8
Q

What is the toxicity of sorafenib?

A

Hand-foot syndrome
Diarrhoea
HTN

9
Q

What evolving combo of biologics is maybe better than sorafenib?

A

Atezolizumab + bevacizumab