医学
肝细胞癌
门静脉血栓形成
报销
血栓形成
流行病学
人口统计学的
内科学
门静脉
放射科
普通外科
外科
医疗保健
经济
人口学
社会学
经济增长
作者
Jian Lü,Xiuping Zhang,Bin‐Yan Zhong,Wan Yee Lau,David C. Madoff,J. Davidson,Xiaolong Qi,Shuqun Cheng,Gao‐Jun Teng
标识
DOI:10.1016/s2468-1253(19)30178-5
摘要
Portal vein tumour thrombosis is common among patients with advanced hepatocellular carcinoma. Tremendous differences exist in the management of hepatocellular carcinoma with portal vein tumour thrombosis between the east and the west, which derive from heterogeneities in its epidemiology, causes, pathology, comorbidities, prognosis, and other demographics. These divergences between the east and the west are not only caused by hepatocellular carcinoma itself, but are also affected by many variables including social factors, physician preferences, accessibility to costly or novel treatments, and reimbursement schemes. In this Review, we compare and contrast the management of hepatocellular carcinoma with portal vein tumour thrombosis in the east and in the west in terms of systemic and surgical treatments, radiotherapy, transcatheter arterial therapies, and portal vein revascularisation. We conclude that a personalised, data-driven approach to care with active management from a multidisciplinary team, as well as increased communication and collaboration between clinicians and researchers based in east and the west, could help to reduce the differences in management and optimise treatment strategies.
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