Multidisciplinary overview of local-regional therapies for liver malignancies

Abstract

This chapter reviews, from the surgeon's perspective, the various local-regional treatments for hepatic malignancies and how the use of stereotactic radiosurgery fits into current general surgical practice. Understanding these modalities is important in surgical practice and enables a rational approach to both surgical and non-surgical therapies for hepatic malignancies. Some of these treatments are clearly in the surgical domain as these therapies may be best given via laparoscopic or open surgical approach. Additionally, these local-regional modalities are increasingly being used as neoadjuvant or adjuvant therapy, particularly in Hepatocellular Carcinoma (HCC). Surgeons are faced with the challenge of adopting these alternative techniques into their practice. Familiarity with these therapies allows the surgeon, with their unique expertise and skill, to participate actively in the nonsurgical management of these lesions. Several of the more prominent nonsurgical local-regional therapies are reviewed here. © 2007 Springer-Verlag Berlin Heidelberg.