Anne Covey, MD, interventional radiologist, Memorial Sloan Kettering Cancer Center, discusses recent and future changes to locoregional treatment approaches for hepatocellular carcinoma (HCC).

For patients with limited disease (small HCC), the guidelines now include ablation as a potentially curative option. Prior to this change, surgery and transplant were the only curative therapies, Covey says.

The locoregional therapy panel has also expanded to include patients with minimal extrahepatic disease who are candidates for arterially directed therapies. Finally, Covey says, select patients who have tumor in the portal vein—this used to be considered a contraindication&mdash;can now receive locoregional therapy.

Covey says there needs to be work done to include imaging follow-up for locoregional therapy in NCCN guidelines. There are several techniques to evaluate response, she says, but the information should be included in guidelines.

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Anne Covey, MD

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Dr. Covey on Recent and Future Changes to the NCCN Guidelines for HCC