Abstract:
Hepatocellular carcinoma (HCC) accounts for approximately 75-90% of primary liver cancers and is the sixth most common cancer and the third leading cause of cancer-related deaths worldwide. In the HIV-positive population, the risk of HCC is approximately four times higher than in the general population, with higher cancer-specific mortality than in HIV-negative patients. In most cases, HCC diagnosis is made in patients younger than the HIV-negative population and in the intermediate-advanced stage, thus limiting the therapeutic possibilities. Treatment choice in HIV-positive patients with HCC is subject to cancer staging, liver function and health status, as for HIV-negative and non-HIV-negative HCC patients. There are relatively few studies on the efficacy and safety in HIV-positive patients to date in loco-regional treatments for HCC. So far, literature shows that curative treatments such as radiofrequency ablation (RFA) have no significant differences in overall survival between HIV-positive and HIV-negative patients, as opposed to palliative treatments such as TACE, where there is a significant difference in overall survival. Although it can be assumed that the most recently discovered loco-regional therapies are applicable to HIV-positive patients with HCC in the same way as HIV-negative patients, further studies are needed to confirm this hypothesis. The purpose of our review is to evaluate these treatments, their efficacy, effectiveness, safety and their applicability to HIV-positive patients.
摘要:
肝细胞癌(HCC)约占原发性肝癌的75-90%,是全球第六大最常见的癌症和第三大癌症相关死亡原因。在艾滋病毒阳性人群中,肝癌的风险大约是普通人群的四倍,癌症特异性死亡率高于HIV阴性患者。在大多数情况下,HCC的诊断是在年轻的患者比HIV阴性人群和中晚期阶段,从而限制了治疗的可能性。HIV阳性HCC患者的治疗选择取决于癌症分期,肝功能和健康状况,至于HIV阴性和非HIV阴性HCC患者。迄今为止,在HCC的局部区域治疗中,对HIV阳性患者的疗效和安全性的研究相对较少。到目前为止,文献显示,治疗如射频消融(RFA)在HIV阳性和HIV阴性患者之间的总生存期没有显着差异,与TACE等姑息治疗相反,总生存率有显著差异。虽然可以假设最近发现的局部区域疗法适用于HIV阳性的HCC患者,与HIV阴性患者相同。需要进一步的研究来证实这一假设。我们审查的目的是评估这些治疗方法,其功效,有效性,安全性及其对HIV阳性患者的适用性。