Cahill Bridget A, Braccia Deborah
Department of Medicine, Northwestern Medical Faculty Foundation, Chicago, IL, USA.
Clin J Oncol Nurs. 2004 Aug;8(4):393-9. doi: 10.1188/04.CJON.393-399.
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. In the United States, the incidence of HCC has increased by nearly 75% since the 1980s. The rise in HCC diagnoses in the United States has been attributed to an increased number of patients infected with viral hepatitis and better diagnostic techniques. The management of HCC begins with diagnostic confirmation, followed by accurate staging. Historically, the prognosis for patients with HCC has been poor; however, improved surveillance and radiologic imaging techniques have led to earlier detection of HCC and an increased opportunity to treat patients. Treatment options for HCC include surgical and nonsurgical modalities. Surgical therapy, by way of partial hepatectomy or orthotopic liver transplantation, is the only potentially curative treatment for HCC, but most patients are not eligible for these procedures by the time of diagnosis. Palliative options include ablative techniques, radiation, and systemic therapies. As the incidence of this malignancy continues to rise, oncology nurses, who are an integral part of the multidisciplinary team caring for these patients, must be aware of current management for HCC. This article will provide an overview of the complex management of patients with HCC in the United States.
肝细胞癌(HCC)是全球第五大常见癌症。在美国,自20世纪80年代以来,HCC的发病率增加了近75%。美国HCC诊断数量的增加归因于感染病毒性肝炎的患者数量增多以及诊断技术的改进。HCC的治疗始于诊断确认,随后是准确分期。从历史上看,HCC患者的预后很差;然而,改进的监测和放射成像技术已导致HCC的早期发现以及治疗患者的机会增加。HCC的治疗选择包括手术和非手术方式。通过部分肝切除术或原位肝移植进行的手术治疗是HCC唯一可能治愈的治疗方法,但大多数患者在诊断时不符合这些手术条件。姑息治疗选择包括消融技术、放疗和全身治疗。随着这种恶性肿瘤的发病率持续上升,作为照顾这些患者的多学科团队不可或缺的一部分,肿瘤学护士必须了解HCC的当前治疗方法。本文将概述美国HCC患者的复杂治疗情况。