Журнал "Гастроэнтерология" Том 60, №1, 2026

Гепатоцелюлярна карцинома залишається однією з найпоширеніших причин онкологічної смертності у світі та є типовим ускладненням хронічних захворювань печінки. Складна взаємодія особливостей пухлинного росту, функціональної здатності печінки, коморбідності, факторів зовнішнього середовища зумовлює необхідність комплексного мультидисциплінарного підходу до ведення таких пацієнтів. Водночас сучасні стратегії лікування і профілактики гепатоцелюлярної карциноми мають ґрунтуватися на інтеграції клінічних, лабораторних та інструментальних даних. В оглядовій статті узагальнено сучасні підходи до лікування і профілактики гепатоцелюлярної карциноми з акцентом на міждисциплінарному підході до схвалення клінічних рішень. Пошук літературних джерел здійснювали в базах даних PubMed/Medline, Scopus, Web of Science, Cochrane Library, Google Scholar, EMBASE, Web of Knowledge Science Citation Index, BIOSIS з використанням ключових слів, що стосуються лікування, профілактики та прогнозу гепатоцелюлярної карциноми. До аналізу включали оглядові статті, настанови міжнародних професійних товариств і результати ключових клінічних досліджень, опубліковані переважно протягом останніх п’яти років. В огляді подані принципи стадіювання захворювання, способи оцінки функціонального резерву печінки й загального стану пацієнта, окреслено роль мультидисциплінарної команди у виборі лікувальної тактики. Детально розглянуто показання до хірургічного лікування, застосування локорегіонарних методів і системної терапії, висвітлено еволюцію системного лікування від таргетних препаратів до сучасної комбінованої імунотерапії. Окремий розділ присвячено стратегіям профілактики гепатоцелюлярної карциноми, включно з імунопрофілактикою, контролем за ефективністю лікування хронічних вірусних гепатитів, зменшенням впливу токсичних і метаболічних чинників і спостереженням після радикального лікування. Отже, комплексний підхід до лікування і профілактики гепатоцелюлярної карциноми дозволяє покращити виживаність і якість життя пацієнтів, а також зменшити ризик рецидиву захворювання.

Hepatocellular carcinoma remains one of the most common causes of cancer-related mortality worldwide and represents a typical complication of chronic liver diseases. The complex interaction between tumor growth characteristics, liver functional capacity, comorbidities, and environmental factors necessitates a comprehensive multidisciplinary approach to the management of these patients. At the same time, modern strategies for the treatment and prevention of hepatocellular carcinoma should be based on the integration of clinical, laboratory, and instrumental data. This narrative review summarizes current approa­ches to the treatment and prevention of hepatocellular carcinoma with an emphasis on interdisciplinary clinical decision-making. A systematic literature search was conducted using the PubMed/Medline, Scopus, Web of Science, Cochrane Library, Google Scholar, Embase, Web of Knowledge Science Citation Index, and BIOSIS databases, employing keywords related to the treatment, prevention, and prognosis of hepatocellular carcinoma. The analysis included review articles, international clinical practice guidelines, and key clinical trial results published predominantly over the past five years. The review presents current principles of disease staging, methods for assessing liver functional reserve and overall patient condition and outlines the role of the multidisciplinary team in selecting optimal treatment strategies. Indications for surgical treatment, the use of locoregional therapies, and systemic treatment options are discussed in detail, and the evolution of systemic therapy from targeted agents to modern combination immunotherapy is highlighted. A separate section is devoted to strategies for the prevention of hepatocellular carcinoma, including immunoprophylaxis, monitoring the effectiveness of treatment for chronic viral hepatitis, reduction of toxic and metabolic risk factors, and surveillance after curative treatment. Thus, a comprehensive approach to the treatment and prevention of hepatocellular carcinoma improves patient survival and quality of life and reduces the risk of disease recurrence.

гепатоцелюлярна карцинома; мультидисциплінарний підхід; BCLC; системна терапія; імунотерапія; профілактика; огляд

hepatocellular carcinoma; multidisciplinary approach; BCLC; systemic therapy; immunotherapy; prevention; review

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