Hepatocellular carcinoma Marek Krawczyk Medical Science Review - Hepatologia 2008; 8 92-99 aaICID: 862363
Article type: Review article
IC™ Value: 3.01
Abstract provided by Publisher
Hepatocellular carcinoma (HCC) is one of the common malignant tumors worldwide. HCC is the fifth leading cause of death on a worldwide basis. The major risk factors for development of HCC are now well defined: chronic viral hepatitis B,C and D, toxins and drugs(e.g. alcohol, aflatoxins, anabolic steroids) and metabolic liver diseases (e.g., hereditary hemochromatosis, alfa1-antitrypsin deficiency).Hepatocarcinogenesis is a multi-step process involving different cellular alteration leading to malignant transformation of the hepatocyte. Clinical presentation is not typical and different, depending on stage at discovery and the geographic location of the patient. Paraneoplastic syndromes including erythocytosis, hypoglikemia and porphyria cutanea tarda are described. AFP is widely used HCC screening test. Routine imaging with USG, CT scan and MRI is the diagnostic procedure and follow abnormal laboratory tests. After that a needle biopsy may be performed, when indicated. The optimal treatment for HCC is surgical resection with the curative intent. However, even after a margin-negative excision, intrahepatic recurrence develops in 70 percent of patients. Most of then represent either multi-focal disease or new primary cancers. This unacceptable results has justified increasing rate of liver transplantation for cancer patients. Percutaneous ethanol injection has been widely performed as an alternative to surgery in patients with small HCCs. Radiofrequebcy ablation produces thermal destruction with an electric current that passes to the tumor via electrode tip, resulting in heat generatin and coagulative necrosis. Transcatheter arterial chemoembolisation is one of the popular and effective treatments for patients with unresectable HCC.