New aspects of diagnosis and therapy of hepatocellular carcinoma

Abstract

Hepatocellular carcinoma is one of the major cancer killers. It affects patients with chronic liver disease who have established cirrhosis, and currently is the most frequent cause of death in these patients. The main risk factors for its development are hepatitis B and C virus infection, alcoholism and aflatoxin intake. If acquistion of risk factors is not prevented and cirrhosis is established, the sole option to improve survival is to detect the tumor at an early stage when effective therapy may be indicated. Early detection plans should be based on hepatic ultrasonography every 6 months, whereas determination of tumor markers is not efficient. Upon detection of a hepatic nodule, there is a need to establish unequivocal diagnosis, either through biopsy or through the application of non-invasive criteria based on the specific radiology appearance of the tumor: fast arterial uptake of contrast followed by venous washout. Effective treatment for liver cancer includes surgical resection, liver transplantation and percutaneous ablation. These options provide a high rate of complete responses and are assumed to improve survival that should exceed 50% at 5 years. If the tumor is diagnosed at an advanced stage, the sole option that improves survival is transarterial chemoembolization. Ongoing research should further advance the time at diagnosis and identify new and effective options targeting molecular pathways governing tumor progression.

Functional interaction between Wnt3 and Frizzled-7 leads to activation of the Wnt/β-catenin signaling pathway in hepatocellular carcinoma cells

“…This phenomenon raises the possibility of activation by upstream components of this cascade. HCC is the major primary malignant tumor of the liver and is a frequent cause of death worldwide [11,12]. Although chronic hepatitis B or C infection and exposure to hepatocarcinogens like aflatoxin B1 and alcohol are well known major risk factors [13], the molecular mechanisms that contribute to tumor initiation or progression remain largely unknown.…”

Hepatotoxicity after Transarterial Chemoembolization and Transjugular Intrahepatic Portosystemic Shunt: Do Two Rights Make a Wrong?

“…Transplantation and surgical resection are considered to be the only curative treatments (3)(4)(5). Only a small percentage of patients with HCC are candidates for resection (6,7).…”

Enhancing the efficacy of photodynamic therapy by a chinese herbal medicine for hepatocellular carcinoma

“…17 In well-selected patients, the five-year survival rate after surgical resection can be as high as 70%. 18 However, only a small percentage of patients with small tumors and excellent liver function are suitable for such a surgical resection.…”

“…With regards to liver transplantation, although it may offer a five year survival rate of more than 70%, 18 in some patients are some of the critical issues impeding the use of liver transplantation as the first-line therapy for HCC. [14][15][16] Newer therapeutic approaches are under continuous investigation and development, especially for patients with non-resectable, nontransplantable, and recurrent HCC.…”