Liver Cancer Treatment in Istanbul
Hepatocellular carcinoma (HCC) and liver metastases are treated at Istanbul JCI centers with surgery, ablation (RFA/MWA), TACE, SIRT Y-90, and systemic therapy (atezolizumab + bevacizumab).
Surgical Resection and Transplant
Hepatic resection for early HCC (Child-Pugh A, single tumor ≤5 cm or 3 tumors ≤3 cm each). Liver transplant (Milan criteria). Robotic resection available.
Locoregional Therapies
- TACE (transarterial chemoembolization) — standard for intermediate HCC
- SIRT Y-90 (SIR-Spheres, TheraSphere) — comparable to TACE, better for large/bilobar
- RFA/MWA — curative for ≤3 cm tumors, 85-90% 5-year OS for early HCC
Systemic Therapy
First-line: atezolizumab + bevacizumab (IMbrave150) or durvalumab + tremelimumab (HIMALAYA). Second-line: regorafenib, cabozantinib, ramucirumab (AFP≥400).
SIRT Y-90 IN ISTANBUL
Y-90 radioembolization (SIR-Spheres) delivers targeted radiation to liver tumors via hepatic artery. Istanbul cost: $12,000-20,000 vs $35,000-60,000 USA.