The assessment of impaired liver function and prognosis in hepatocellular carcinoma.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Expert Review of Gastroenterology & Hepatology Pub Date : 2024-12-01 Epub Date: 2025-01-07 DOI:10.1080/17474124.2024.2442573

Roxana Pantea, Jan Bednarsch, Sophia Schmitz, Phil Meister, Daniel Heise, Florian Ulmer, Ulf Peter Neumann, Sven Arke Lang

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Abstract

Introduction: The impairment of liver function strongly limits the therapeutic options for hepatocellular carcinoma (HCC), and the assessment of liver function is key to finding the appropriate therapy for patients suffering from this disease. Furthermore, preexisting liver dysfunction has a negative impact on the prognosis of patients in addition to the malignant potential of HCC. Hence, defining the optimal treatment of patients with HCC requires a comprehensive examination with liver function being a crucial part of it.

Areas covered: This review will provide an overview of the currently existing methods for evaluating the liver function in patients with HCC. Assessment of liver function includes scoring systems but also functional and technical methods. In addition, the role of these tests in different treatment facilities such as liver resection, transplantation, interventional and systemic therapy is summarized.

Expert opinion: A comprehensive pretherapeutic assessment of the liver function includes laboratory-based scoring systems, as well as imaging- and non-imaging-based functional tests. Combining diverse parameters can help to improve the safety and efficacy of HCC therapy particularly in patients with compromised liver function. Future research should focus on optimizing pretherapeutic assessment recommendations for each therapy.

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肝细胞癌肝功能损害及预后评估。

肝功能损害严重限制了肝细胞癌（HCC）的治疗选择，肝功能评估是寻找合适治疗方法的关键。此外，除了HCC的恶性潜能外，既往存在的肝功能障碍也会对患者的预后产生负面影响。因此，确定HCC患者的最佳治疗方案需要全面检查，肝功能是其中至关重要的一部分。涵盖领域：本综述将概述目前评估HCC患者肝功能的方法。肝功能评估包括评分系统，也包括功能和技术方法。此外，综述了这些检测在肝切除、肝移植、介入和全身治疗等不同治疗手段中的作用。专家意见：全面的治疗前肝功能评估包括基于实验室的评分系统，以及基于影像学和非影像学的功能检查。结合多种参数有助于提高HCC治疗的安全性和有效性，特别是对肝功能受损的患者。未来的研究应侧重于优化每种疗法的治疗前评估建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.