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BackTable / Tumor Board / Podcast / Episode #5
Complex HCC Patients & The "Grey Zone": What To Do When You Don’t Know What To Do
with Dr. Adam Burgoyne, Dr. Zach Berman, Dr. Kirema Garcia-Reyes and Dr. Lingling Du
Treatment of hepatocellular carcinoma (HCC), like that of many other cancers, spans a spectrum from curative to palliative intent. To explore the "grey zone" of treatment goals for intermediate-stage HCC patients, Dr. Sabeen Dhand interviews a panel of experts in the field: medical oncologists Dr. Adam Burgoyne and Dr. Lingling Du, along with interventional radiologists Dr. Kirema Garcia-Reyes and Dr. Zachary Berman.
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BackTable, LLC (Producer). (2025, January 17). Ep. 5 – Complex HCC Patients & The "Grey Zone": What To Do When You Don’t Know What To Do [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Adam Burgoyne
Dr. Adam Burgoyne is a gastrointestinal / hepatobiliary oncologist and associate clinical professor with Ochsner Health in New Orleans, Louisiana.
Dr. Zach Berman
Dr. Zachary Berman is an interventional radiologist at the University of California San Diego in San Diego, California.
Dr. Kirema Garcia-Reyes
Dr. Kirema Garcia-Reyes is an interventional radiologist and assistant professor with Mount Sinai in New York City.
Dr. Lingling Du
Dr. Lingling Du is an oncologist with Ochsner Health in New Orleans, Louisiana.
Dr. Sabeen Dhand
Dr. Sabeen Dhand is a practicing interventional radiologist with PIH Health in Los Angeles.
Synopsis
The discussion begins with an explanation of the Barcelona-Clinic Liver Cancer (BCLC) staging system. While this system takes into account helpful factors such as liver function, performance status, and tumor burden, it fails to fully capture the true heterogeneity of the HCC patient population. Additional considerations include tumor biology, response to previous treatments, and the location of metastases. The specialists then share their experiences in treating patients with comorbid gastrointestinal cancers and mixed tumors, discuss the benefits of an interventional oncology clinic setting, and highlight virtual opportunities for connecting with tumor boards. They also offer advice on patient education regarding treatment options.
Timestamps
00:00 - Introduction to BCLC Staging
03:02 - Impact of Performance Status
06:29 - Predictors of Survival in HCC
09:51 - Palliative versus Curative Treatment Intent
13:55 - Comorbid and Mixed Gastrointestinal Cancers
16:51 - Adverse Effects of Treatment
20:37 - Interventional Oncology in the Clinic Setting
23:06 - Navigating Multiple Provider Viewpoints
28:01 - Complex Case Examples
Resources
BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update (Reig et al, 2022):
https://www.journal-of-hepatology.eu/article/S0168-8278(21)02223-6/fulltext
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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