HCC

Question 1

CLIP scoring for HCC

Answer 1

score 0-6. CP score A-0, B-1, C-2,

Question 2

phase III SHARP trial HCC

Answer 2

sorafenib OS improvement, 10.7v7.9mo

Question 3

sorafenib adverse events

Answer 3

hand-foot (dose-limiting, monitor symptoms), diarrhea, fatigue, GI bleeds rare

Question 4

sorafenib response criteria

Answer 4

difficult to see response.

Question 5

sorafenib with elevated LFTs

Answer 5

if bili 1.5-3x ULN, 1/2 dose sorafenib, if >3, safety not established. if albumin <2.5, 1 pill a day

Question 6

adjuvant sorafenib

Answer 6

no benefit

Question 7

gallbladder epi

Answer 7

higher in women, hot spots in south america, chile, equador, india/

Question 8

etiologies gallbladder

Answer 8

IBD, porcelain gallbaldder,

Question 9

intrahepatic cholangiocarcinoma

Answer 9

from liver fluke worm in thailand

Question 10

tumor with chole

Answer 10

standard is to close and not operate- studding

Question 11

adjuvant therapy for gallbladder

Answer 11

Horgan AM JCO 2012 meta-analysis- favors giving adjuvant chemotherapy on case-by-case basis. not sure for intrahepatic cholangio.

Question 12

metastatic disease, gallbladder

Answer 12

cis/gem v. gem–> improved PFS and OS

Question 13

fibrolamellar HCC

Answer 13

younger, more likely resectable, less associated w ifn causes

Question 14

AFP for detection

Answer 14

not reliable to discern cirrhosis from cancer. can get AFP-L3% which is more specific for HCC

Question 15

percutaneous ablation for HCC

Answer 15

only do for unresectable, localized disease. 80% CR in

Question 16

RFA versus other local ablative techniques

Answer 16

RFA may be superior

Question 17

transplant for HCC

Answer 17

for unresectable disease, especially if cirrhosis also will benefit

Question 18

sorefinib indications

Answer 18

systemic disease with child-pugh A or B7

Question 19

chemoembolization for HCC

Answer 19

can do if no distant mets. not substitute for resection