No

2. Rashed, W.M., Kandeil, M.A.M., Mahmoud, M.O. and Ezzat, S.,
2020. Hepatocellular Carcinoma (HCC) in Egypt: A
comprehensive overview. Journal of the Egyptian National
Cancer Institute, 32(1), pp.1-11.

10. percutaneous ethanol injection [PEI] or radiofrequency ablation [RFA])

15. Trans arterial chemo-embolization
Trans arterial radio therapy
Radio Frequency Ablation
Percutaneous Ethanol Injection

18. If Potential remnant liver volume is less, consider the following:
• Portal vein embolization.
• TACE

36. HAIC, hepatic
arterial infusion
chemotherapy;
Vp3, primary
branch portal
vein invasion;
Vp4, main portal
vein invasion.

40. Modality Selection criteria Disadvantages
RESECTION Small lesions
Good liver preserve Few co-morbidity
No extra hepatic, L.N vascular invasion
Only 10-20% eligible
TRANSPLANT UNOS Milán criteria: <5cm, 3 x <3cm Limited resource, Long waiting list
Patient's deteriorate while waiting
RF ABLATION Small lesions
<3cm
Away from blood vessels
Accessible location-away from dome, diaphragm
Invasive
Heat injury to surrounding organs
Heat sink effect
Dome tumors less suited
TACE Non Surgical HCC
intermediate stage patients
multifocal liver-disease
no vascular invasion; no shunting; no extra hepatic
disease
Risk of complications with portal vein
thrombus.
Local control may not be sustained
Not suitable for lesion > 10cm
Contraindicated in shunting
Y-90 TART Same as TACE
Portal vein thrombosis
Potential for radiation pneumonitis
SBRT Max size 6cm
3 lesions, all <3cm
700 ml normal liver able to spared
PVT allowed, Any location
Radiation damage to liver and
surrounding organs
Limited level 1 data, no RCT