Ep. 517 Complex HCC Patients and the "Grey Zone": What to Do When You Don’t Know What to Do

BackTable Vascular & Interventional

Treatment of hepatocellular carcinoma (HCC), like that of many other cancers, spans a spectrum from curative to palliative intent. To explore the "grey zone" of treatment goals for intermediate-stage HCC patients, Dr. Sabeen Dhand interviews a panel of experts in the field: medical oncologists Dr. Adam Burgoyne and Dr. Lingling Du, along with interventional radiologists Dr. Kirema Garcia-Reyes and Dr. Zachary Berman.

Physicians, nurses, nurse practitioners, and physician assistants can follow this link to earn CME / CE credits for completing an accredited learning activity related to this discussion:

https://www.cmeuniversity.com/course/take/125739

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This podcast is supported by an educational grant from AstraZeneca Pharmaceuticals and Boston Scientific.

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SYNPOSIS

The discussion begins with an explanation of the Barcelona-Clinic Liver Cancer (BCLC) staging system. While this system takes into account helpful factors such as liver function, performance status, and tumor burden, it fails to fully capture the true heterogeneity of the HCC patient population. Additional considerations include tumor biology, response to previous treatments, and the location of metastases. The specialists then share their experiences in treating patients with comorbid gastrointestinal cancers and mixed tumors, discuss the benefits of an interventional oncology clinic setting, and highlight virtual opportunities for connecting with tumor boards. They also offer advice on patient education regarding treatment options.

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TIMESTAMPS

00:00 - Introduction to BCLC Staging

03:02 - Impact of Performance Status

06:29 - Predictors of Survival in HCC

09:51 - Palliative versus Curative Treatment Intent

13:55 - Comorbid and Mixed Gastrointestinal Cancers

16:51 - Adverse Effects of Treatment

20:37 - Interventional Oncology in the Clinic Setting

23:06 - Navigating Multiple Provider Viewpoints

28:01 - Complex Case Examples

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RESOURCES

BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update (Reig et al, 2022):

https://www.journal-of-hepatology.eu/article/S0168-8278(21)02223-6/fulltext

CME Accreditation Information:

https://f7cae4ec-b69e-490d-9e0f-19b16a6f146d.usrfiles.com/ugd/f7cae4_a7c37ea3cd1b4d3fa53d5edf8dfe255b.pdf