New advances in hepatocellular carcinoma

Abstract

Hepatocellular carcinoma (HCC) is the leading cause of deaths in cirrhotic patients and the third cause of cancer related deaths. Most HCC are associated with well known underlying risk factors, in fact, HCC arise in cirrhotic patients in up to 90% of cases, mainly due to chronic viral hepatitis and alcohol abuse. The worldwide prevention strategies are conducted to avoid the infection of new subjects and to minimize the risk of liver disease progression in infected patients. HCC is a condition which lends itself to surveillance as at-risk individuals can readily be identified. The American and European guidelines recommended implementation of surveillance programs with ultrasound every six months in patient at-risk for developing HCC. The diagnosis of HCC can be based on non-invasive criteria (only in cirrhotic patient) or pathology. Accurately staging patients is essential to oncology practice. The ideal tumour staging system in HCC needs to account for both tumour characteristics and liver function. Treatment allocation is based on several factors: Liver function, size and number of tumours, macrovascular invasion or extrahepatic spread. The recommendations in terms of selection for different treatment strategies must be based on evidence-based data. Resection, liver transplant and interventional radiology treatment are mainstays of HCC therapy and achieve the best outcomes in well-selected candidates. Chemoembolization is the most widely used treatment for unresectable HCC or progression after curative treatment. Finally, in patients with advanced HCC with preserved liver function, sorafenib is the only approved systemic drug that has demonstrated a survival benefit and is the standard of care in this group of patients.

Oncogene dependent requirement of fatty acid synthase in hepatocellular carcinoma

“…Among primary liver malignancies, hepatocellular carcinoma (HCC) is the most prevalent: it affects approximately one million individuals annually in the world, with the incidence roughly equal to the mortality rate. [1][2][3] The occurrence of HCC is highest in men, and the discrepancy in the geographical distribution of HCC reflects the differences in exposure to hepatitis viruses and distinct environmental pathogens. The incidence is highest in East Asia and Sub-Saharan Africa, representing about 85% of the total number of cases worldwide, while in most industrialized countries HCC occurrence is low, except for Southern Europe.…”

“…The incidence is highest in East Asia and Sub-Saharan Africa, representing about 85% of the total number of cases worldwide, while in most industrialized countries HCC occurrence is low, except for Southern Europe. [1][2][3] Multiple risk factors have been linked to the development of HCC, with chronic viral hepatitis (B and C) infection, alcohol abuse, non-alcoholic steatohepatitis (NASH), presence of diabetes and/or metabolic syndrome, and exposure to aflatoxins being the most frequent; nonetheless, HCC can also occur in people without any known risk factor. [4][5][6] The clear majority of HCC patients are diagnosed with an advanced disease, often precluding potentially effective therapies such as liver transplantation or curative partial liver resection.…”

A hepatocellularis carcinoma előfordulása és kezelésének tanulságai az északkelet-magyarországi régióban

“…A májzsugor annak bármely stádiumában és bármely etiológia esetén a HCC kialakulásának fokozott kockázatával jár. A májzsugorban szenvedők 30-35%-ában várható a tumor megjelenése [3]. A világstatisztikai adatok szerint leggyakrabban vírushepatitis (körülbelül 50%), alkoholos májkárosodás (mintegy 25%) vagy nem alkoholos steatohepatitis áll a háttérben (megközelítőleg 10%), de ezek mellett minden olyan betegség, amely májzsugor kialakulásához vezethet, szerepelhet oki té-nyezőként a tumor patogenezisében.…”

“…A reszekció csak a sebészi reszekciós vonalak mentén történhet (fontos a megmaradt máj vér-rel és epecsatornával történő ellátottsága), amely mindenképpen a tumor méretéhez képest jelentősebb parenchymavesztéssel jár. A legtöbbször jelen lévő máj-zsugor miatt a műtét előtt mérlegelni kell a maradék máj rezerv kapacitását [3]. A BCLC szerinti korai (A), illetve igen korai (0) stádiumban a műtétet követően az 5 éves túlélés 70 és 90% [9].…”

A Rare Association between Left Lobe Secondary Biliary Cirrhosis and Budd-Chiari Syndrome Secondary to Hepatocellular Carcinoma in the Non-Cirrhotic Right Liver Lobe

“…Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide [1], and mostly arises in the setting of underlying cirrhosis (90% of the cases) regardless of its etiology [2]. Rarely it may also occur in a nonfibrotic liver [3].…”