Hepatocellular carcinoma: natural history, current management, and emerging tools

Christopher L Tinkle, Daphne Haas-KoganDepartment of Radiation Oncology, University of California, San Francisco, CA, USAAbstract: Hepatocellular carcinoma (HCC) is the most common primary liver tumor and represents the third-leading cause of cancer-related death in the world. The incidence of HCC c...

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Autores principales:	Tinkle CL, Haas-Kogan D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/59d7f77f13714bb9beea57cab8e60d4b
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spelling	oai:doaj.org-article:59d7f77f13714bb9beea57cab8e60d4b2021-12-02T01:52:07ZHepatocellular carcinoma: natural history, current management, and emerging tools1177-54751177-5491https://doaj.org/article/59d7f77f13714bb9beea57cab8e60d4b2012-07-01T00:00:00Zhttp://www.dovepress.com/hepatocellular-carcinoma-natural-history-current-management-and-emergi-a10429https://doaj.org/toc/1177-5475https://doaj.org/toc/1177-5491Christopher L Tinkle, Daphne Haas-KoganDepartment of Radiation Oncology, University of California, San Francisco, CA, USAAbstract: Hepatocellular carcinoma (HCC) is the most common primary liver tumor and represents the third-leading cause of cancer-related death in the world. The incidence of HCC continues to increase worldwide, with a unique geographic, age, and sex distribution. The most important risk factor associated with HCC is liver cirrhosis, with the majority of cases caused by chronic infection with hepatitis B (HBV) and C (HCV) viruses and alcohol abuse, although nonalcoholic fatty liver disease is emerging as an increasingly important cause. Primary prevention in the form of HBV vaccination has led to a significant decrease in HBV-related HCC, and initiation of antiviral therapy appears to reduce the incidence of HCC in patients with chronic HBV or HCV infection. Additionally, the use of ultrasonography enables the early detection of small liver tumors and forms the backbone of recommended surveillance programs for patients at high risk for the development of HCC. Cross-sectional imaging studies, including computed tomography and magnetic resonance imaging, represent further noninvasive techniques that are increasingly employed to diagnose HCC in patients with cirrhosis. The mainstay of potentially curative therapy includes surgery &ndash; either resection or liver transplantation. However, most patients are ineligible for surgery, because of either advanced disease or underlying liver dysfunction, and are managed with locoregional and/or systemic therapies. Randomized controlled trials have demonstrated a survival benefit with both local therapies, either ablation or embolization, and systemic therapy in the form of the multikinase inhibitor sorafenib. Despite this, median survival remains poor and recurrence rates significant. Further advances in our understanding of the molecular pathogenesis of HCC hold promise in improving the diagnosis and treatment of this highly lethal cancer.Keywords: hepatocellular carcinoma, viral hepatitis, liver transplantation, ablation, embolization, sorafenibTinkle CLHaas-Kogan DDove Medical PressarticleMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol 2012, Iss default, Pp 207-219 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Tinkle CL Haas-Kogan D Hepatocellular carcinoma: natural history, current management, and emerging tools
description	Christopher L Tinkle, Daphne Haas-KoganDepartment of Radiation Oncology, University of California, San Francisco, CA, USAAbstract: Hepatocellular carcinoma (HCC) is the most common primary liver tumor and represents the third-leading cause of cancer-related death in the world. The incidence of HCC continues to increase worldwide, with a unique geographic, age, and sex distribution. The most important risk factor associated with HCC is liver cirrhosis, with the majority of cases caused by chronic infection with hepatitis B (HBV) and C (HCV) viruses and alcohol abuse, although nonalcoholic fatty liver disease is emerging as an increasingly important cause. Primary prevention in the form of HBV vaccination has led to a significant decrease in HBV-related HCC, and initiation of antiviral therapy appears to reduce the incidence of HCC in patients with chronic HBV or HCV infection. Additionally, the use of ultrasonography enables the early detection of small liver tumors and forms the backbone of recommended surveillance programs for patients at high risk for the development of HCC. Cross-sectional imaging studies, including computed tomography and magnetic resonance imaging, represent further noninvasive techniques that are increasingly employed to diagnose HCC in patients with cirrhosis. The mainstay of potentially curative therapy includes surgery &ndash; either resection or liver transplantation. However, most patients are ineligible for surgery, because of either advanced disease or underlying liver dysfunction, and are managed with locoregional and/or systemic therapies. Randomized controlled trials have demonstrated a survival benefit with both local therapies, either ablation or embolization, and systemic therapy in the form of the multikinase inhibitor sorafenib. Despite this, median survival remains poor and recurrence rates significant. Further advances in our understanding of the molecular pathogenesis of HCC hold promise in improving the diagnosis and treatment of this highly lethal cancer.Keywords: hepatocellular carcinoma, viral hepatitis, liver transplantation, ablation, embolization, sorafenib
format	article
author	Tinkle CL Haas-Kogan D
author_facet	Tinkle CL Haas-Kogan D
author_sort	Tinkle CL
title	Hepatocellular carcinoma: natural history, current management, and emerging tools
title_short	Hepatocellular carcinoma: natural history, current management, and emerging tools
title_full	Hepatocellular carcinoma: natural history, current management, and emerging tools
title_fullStr	Hepatocellular carcinoma: natural history, current management, and emerging tools
title_full_unstemmed	Hepatocellular carcinoma: natural history, current management, and emerging tools
title_sort	hepatocellular carcinoma: natural history, current management, and emerging tools
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/59d7f77f13714bb9beea57cab8e60d4b
work_keys_str_mv	AT tinklecl hepatocellularcarcinomanaturalhistorycurrentmanagementandemergingtools AT haaskogand hepatocellularcarcinomanaturalhistorycurrentmanagementandemergingtools
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Hepatocellular carcinoma: natural history, current management, and emerging tools

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