Management of “very early” hepatocellular carcinoma on cirrhotic patients

Abstract

Due to the advances in screening of cirrhotic patients, hepatocellular carcinoma (HCC) is being diagnosed in earlier stages. For this reason the number of patients diagnosed of very early HCC (single tumors ≤ 2 cm) is continuously increasing. Once a patient has been diagnosed with this condition, treatment strategies include liver resection, local therapies or liver transplantation. The decision on which therapy should the patient undergo depends on the general patients performance status and liver disease. Anyway, even in patients with similar conditions, the best treatment offer is debatable. In this review we analyze the state of the art on the management of very early HCC on cirrhotic patients to address the best treatment strategy for this patient population.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words: Hepatocellular carcinoma; Very early; Liver resection; Liver transplantation; Local therapiesCore tip: Very early hepatocellular carcinoma patients are deemed too early for liver transplantation candidacy, known as the best treatment regarding long-term survival and tumor recurrence. Strategies as surgical resection and radiofrequency ablation have gained popularity. Although resection is considered as the first line of treatment, recent studies claim equal results with ablation techniques. Ablation used as a test of time in patients who remain candidates for liver transplantation is attractive. In this review we will analyze in detail the novel strategy repertoire used in the management of these patients.Sapisochin G, Fernandez de Sevilla E, Echeverri J, Charco R. Management of "very early" hepatocellular carcinoma on cirrhotic patients.

Magnetic Resonance Imaging Is Cost‐Effective for Hepatocellular Carcinoma Surveillance in High‐Risk Patients With Cirrhosis

“…(29) In contrast, the higher detection rates of very early-stage HCC by MRI allowed more patients to receive curative treatments, especially RFA, which is one of the standard treatment options for very early-stage HCC due to its less invasive nature and low cost. (10,30,31) In our analysis using prospective data on surveillance, the proportion of RFA use was 52.2% in patients with very early-stage HCC, whereas it was only 23.7% in patients with early-stage HCC. RFA was, in fact, the least costly among the various treatment options for HCC (RFA, resection, LT, and transarterial chemoembolization) in our model.…”

“…The quality of US is especially low in patients with advanced cirrhosis, obesity, and nonalcoholic steatohepatitis; and US was inadequate for excluding HCC in over one third of those patients . In contrast, the higher detection rates of very early‐stage HCC by MRI allowed more patients to receive curative treatments, especially RFA, which is one of the standard treatment options for very early‐stage HCC due to its less invasive nature and low cost . In our analysis using prospective data on surveillance, the proportion of RFA use was 52.2% in patients with very early‐stage HCC, whereas it was only 23.7% in patients with early‐stage HCC.…”

MicroRNA-107: a novel promoter of tumor progression that targets the CPEB3/EGFR axis in human hepatocellular carcinoma

“…HCC is the most common type of primary liver cancer and is the third leading cause of cancer-related death [ 22 ]. Proliferation and metastasis, two of the most important hallmarks of cancer, are the leading lethal factors for malignant cancer, especially for HCC [ 1 , 23 , 24 ].…”

MicroRNA‑9 enhances sensitivity to cetuximab in epithelial phenotype hepatocellular carcinoma cells through regulation of the eukaryotic translation initiation factor 5A‑2

“…Hepatocellular carcinoma (HCC) is one of the most common primary malignancies of the liver, the third leading cause of cancer-associated mortalities after stomach and lung cancer, and the sixth most common neoplasm worldwide ( 1 , 2 ). Current treatments for HCC include chemotherapy, radiotherapy and surgical intervention.…”