Department of Radiation Oncology, Stanford Cancer Institute, Stanford, CA.
Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
Multi-Organ Transplant, Toronto General Surgery, Department of General Surgery, University of Toronto, Toronto, Ontario, Canada.
Division of Interventional Radiology, University of Toronto, Toronto, Ontario, Canada.
Department of Radiation Oncology, University of Michigan, Ann Arbor, MI.
Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, IL.
Department of Radiation Oncology, Stanford Cancer Institute, Stanford, CA. Electronic address: firstname.lastname@example.org.
Surgical resection or liver transplantation offers the best chance of cure for patients with hepatocellular carcinoma (HCC). Unfortunately, most patients are not good candidates for liver resection due to locally advanced disease or compromised liver function. Moreover, liver transplantation waiting lists are long. For those cases not amenable for resection, a variety of local treatment modalities are available, such as image-guided ablative procedures, transarterial chemoembolization, and radioembolization, as well as external beam radiation. HCC presentation can vary considerably in size, number, and location of lesions. The management of inoperable HCC is, therefore, quite complex, and there is a lack of consensus on the best local treatment modality for each type tumor presentation. Here, we present 4 clinical case scenarios representative of commonly seen cases in the clinical setting, with different therapeutic perspectives from institutions with high expertise in the management of HCC.