Hepatobiliary Malignancies: Lessons from AsiaWong T.C.L. · Poon R.T.P.
Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
With the higher incidences of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) in the East compared with the West, Asian centers have made significant contributions to the management of these malignancies. The major risk factor for HCC is hepatitis B infection in Asia in contrast to hepatitis C in Western populations. Barcelona Clinic for Liver Cancer (BCLC) staging that guides the treatment of patients with HCC in the West is considered too conservative by many Asian centers. In Asia, liver resection is widely offered to patients with multifocal, bilobar tumor or tumor invasion to the portal vein. The criteria for liver transplantation for HCC are also often more extended in Asian centers. Asian surgeons pioneered the development of living donor liver transplantation, which plays a major role in the management of early HCC associated with severe cirrhosis in Asia due to shortage of deceased donor graft. Asian centers have also made significant contributions to the modern management of CCA. A more aggressive surgical approach is generally adopted in Asia, including radical lymphadenectomy for intrahepatic CCA and simultaneous hepatic artery and portal vein resection with hepatectomy for hilar CCA. Eastern and Western centers should collaborate in further studies to establish the optimal treatment strategies for hepatobiliary malignancies.
© 2013 S. Karger AG, Basel
Prof. Ronnie T.P. Poon
Department of Surgery
The University of Hong Kong, Queen Mary Hospital
102 Pokfulam Road, Hong Kong (China)
Published online: June 17, 2013
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 0, Number of References : 81
Digestive Diseases (Clinical Reviews)
Vol. 31, No. 1, Year 2013 (Cover Date: June 2013)
Journal Editor: Malfertheiner P. (Magdeburg)
ISSN: 0257-2753 (Print), eISSN: 1421-9875 (Online)
For additional information: http://www.karger.com/DDI