Hepatocellular carcinoma: early-stage management challenges

Abstract

Hepatocellular carcinoma (HCC) is a major cause of cancer death and is increasing in incidence. This review focuses on HCC surveillance and treatment of early-stage disease, which are essential to improving outcomes. Multiple societies have published HCC surveillance guidelines, but screening efforts have been limited by noncompliance and overall lack of testing for patients with undiagnosed chronic liver disease. Treatment of early-stage HCC has become increasingly complex due to expanding therapeutic options and better outcomes with established treatments. Surgical indications for HCC have broadened with improved preoperative liver testing, neoadjuvant therapy, portal vein embolization, and perioperative care. Advances in post-procedural monitoring have improved efficacies of transarterial chemoembolization and radiofrequency ablation, and novel therapies involving delivery of radiochemicals are being studied in small trials. Finally, advances in liver transplantation have allowed for expanded indications beyond Milan criteria with non-inferior outcomes. More clinical trials evaluating new therapies and multimodal regimens are necessary to help clinicians design better treatment algorithms and improve outcomes.

Identification of novel biomarkers of hepatocellular carcinoma by high‐definition mass spectrometry: Ultrahigh‐performance liquid chromatography quadrupole time‐of‐flight mass spectrometry and desorption electrospray ionization mass spectrometry imaging

“…Hepatocellular carcinoma (HCC), the primary type of liver cancer, is highly malignant and is continuing to increase worldwide. The five‐year survival rate is less than 15%, and HCC is the second leading cause of death in East Asia . Early diagnosis of HCC is necessary to reduce the number of deaths and maintain quality of life with cancer.…”

“…The fiveyear survival rate is less than 15%, and HCC is the second leading cause of death in East Asia. 1 Early diagnosis of HCC is necessary to reduce the number of deaths and maintain quality of life with cancer. α-Fetoprotein (AFP) and a protein induced by vitamin K absence or antagonist-2 (PIVKA-II) are conventionally used as diagnostic markers for HCC.…”

“…9Z) in anhydrous pyridine for 4 h at room temperature.After purification with a silica gel column, the TG 16:0/18:1(9Z)/ 20:1(11Z) was obtained as colorless oil (yield 73.6%) 1. H NMR (CDCl 3 , δ): 0.86 (t, J = 6.5 Hz, 9H, -CH 3 ), 1.18-1.39 (m, 68H, -CH 2 -), 2.00 (m, 8H, -C¼C-CH 2 -), 2.24-2.36 (m, 6H, -OCO-CH 2 -), 4.14 (dd, J = 11.8 and 5.9 Hz, 2H, 1-H and 3-H), 4.29 (dd, J = 11.6 and 4.0 Hz, 2H, 1-H and 3-H), 5.26 (tt, J = 5.9 and 4.4 Hz, 1H, 2-H), and 5.29-5.39 ppm (m, 4H, -CH¼CH-), data which were in accordance with a previous study.…”

Development and Validation of a Tool to Assess Hepatocellular Carcinoma Knowledge among Hepatocellular Carcinoma Patients in Taiwan

“…In year 2018, it is estimated about 841,080 new cases globally [1]. Hepatocellular cancer is the second leading cause of cancer death in East Asia and sub-Saharan Africa and the sixth most common in Western countries [1] [2].…”

Fluorescent peptide highlights micronodules in murine hepatocellular carcinoma models and humans in vitro

“…Surgical resection remains the main treatment option for hepatocellular carcinoma (HCC), one of the leading malignancies worldwide . The stage at diagnosis and degree of tumor removal largely determine the postsurgical prognosis.…”