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Chok Surgical strategy for huge/advanced HCC

DOWNSTAGING treatment modalities are still evolving. ALPPS will
continue to be developed and more long-term results
Both TACE and radioembolization are safe and effective will be available in the near future.
in highly selected patients. Radioembolization may
confer a survival benefit over sorafenib on advanced- DECLARATIONS
stage patients. Radioembolization is preferable to
TACE for advanced-stage patients, especially those Authors’ contributions
with macrovascular invasion, since TACE might K.S.H. Chok contributed solely to this paper.
induce liver failure. [53] However, the effectiveness of
downstaging is not conclusive, as most of the cases Financial support and sponsorship
reported were limited by poor underlying liver function. None.

EXTRAHEPATIC METASTASIS Conflicts of interest

Lung is the most common site for extrahepatic The author has no conflicts of interest with regard to
metastasis of HCC. [54] A previous study by our the study or its publication.
center reported that metastasectomy conferred a
survival benefit on HCC patients who developed lung Patient consent
metastasis after hepatectomy. [55] Overall survival Not applicable.
was compared in patients with resectable and
unresectable lung metastases and in two periods (Era Ethics approval
1: 1989-1995, Era 2: 1996-2010). The median survival Not applicable.
duration of patients with resectable and unresectable
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