JCMS 2017: Chula-RAMA-SI survey through the biomedical knowledge (3)

15 September 2015 (last day!)

Attend only one session

HCC

Early Diagnostic and Screening (Dr.Taya)

Top ten tips

Survival is poor

Thailand is the number one in Asian pacific region

Survival is very low since patients always comes when chronic

How to improve - using the bclc staging system which has the criteria to treat in each step (it is basically in Spain

Step by step to make it better

Prevention

Early diagnostic

Treatment

Palliation

Symptoms occur late, detection late cause patients to have low survival rate 

90.2% does not get the targeted-therapy

Early diagnostic; screening increases the early stage of the detections and improve survival rate

Problem on the screening like ultrasound (some ppl cannot afford), doctors might miss recognition the risk of hbv, sound like it still has a problem on the screening

Surgery and Liver Transplantation (Dr.Prawat)

Next for the treatment (surgery and transplantation)

Surgical resection may be better than rfa

However, there are the obstacles on this treatment too, depending on the tumor location, some cannot be done or when part of the liver is removed the remaining function could not longer active leading to organ failure

Liver transplantation - improve a bit but still not good enough - there is the criteria which some of the patients can undergo liver transplantation - if not using criteria, the outcome will be very poor.

Non-invasive approach (Dr.Natcha)

This is basically for the patients who the liver could be removed by the surgery) - using either radio or chemotherapy to treat the cancer

Rfa is less invasive compared to liver remove - it could be repeated esp. for the patients with cirrhosis who can easily have recurrent. Fewer rate of mortality and morbidity. 

Chemoembolization (TACE, using the image guide to introduce the chemo) patients which good selection would help good outcome; the concept for this technique is that preserve the normal function but the tumor must be killed

Nano tools will help this kind of cancer since it is really hard to treat the tumor in this organ (good response vs less toxicity)

Tumor has good treatment from TACE - but there is the factor from microenvironment that causes the cancer to survive and there is the recurrent. 

Targeted therapy - 

Can prolong the patients' life 

Some have side affect and the price is very expensive

Last point;

Palliative care -

What do the patients want?

How do they feel?

So the team can plan what they can do to relieve  the symptom

In conclusion

Improve outcome --

Screening and early detection

Improve method for Hepatectomy

Liver transplantation - initiate more donor