HCC 2 Flashcards

1
Q

When do you not need liver biopsy of a suspicious lesion?

A

LI-RADS 5 lesion in cirrhotic liver or in a patient with chronic HBV without cirrhosis

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2
Q

How to workup a LI-RADS 3 lesion?

A

Repeat imaging in 3-6 months

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3
Q

What defines early HCC?

A

<3 tumors
No extrahepatic spread
No vascular invasion

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4
Q

Teratment options (3) of early HCC?

A

Transplant, Surgery, TACE

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5
Q

Criteria for resectable HCC? (2)

A

Size and function.
Liver remnant must be >25-30%
and preserved liver function

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6
Q

Patient with early HCC undergoes surgical resection. What now?

A

Adjuvant atezo-bev improved RFS

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7
Q

What makes a patient with HCC a transplant candidate? (2)

A

Unresectable
1 lesion <5cm or 3 tumors that are 3 cm or smaller

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8
Q

Criteria for HCC ablation? (3)

A

Each lesion up to 4 cm
Child Pugh A or B
Not near major blood vessel

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9
Q

Patient with unresectable HCC with Child Pugh B and no extrahepatic disease or vascular invasion. What to do for teratment?

A

TACE, TARE, or RFA

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10
Q

1st line treatment for advanced HCC (2)

A

Atezo + Bev
Durva + Tremelimumab

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11
Q

2nd line therapy for advanced HCC? (5)

A

Regorafenib
Cabozantinib
Ramucirumab (If AFP >400)
Ipi/Nivo
Lenvatinib
Sorafenib
Pembro

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12
Q

Indication for Ramuricumab in advanced HCC?

A

2nd line, if AFP >400

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13
Q

Treatment options for 1st line advanced HCC with Child Pugh B?

A

Sorafenib (B7)
Nivo
Atezo-Bev
Durva

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14
Q

Second line therapy options for advanced HCC with Child Pugh B? (2)

A

Sorafenib (B7)
Nivo

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15
Q

Patient with advanced HCC about to start treatment with Atezo + Bev. What needs to be done within the first 6 months of treamtent?

A

EGD to rule out varices

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16
Q

What histology has the best prognosis of HCC?

A

Fibrolamellar

17
Q

What is the largest lesion that can be treated with ablation

A

3 cm

18
Q

Contraindications to offer TACE

A

Child Pugh C
Portal vein thrombosis or tumor invasion
Bilirubin >3