Changing epidemiology of HCC in Italy

Size: px
Start display at page:

Download "Changing epidemiology of HCC in Italy"

Transcription

1 Changing epidemiology of HCC in Italy G. Svegliati-Baroni Clinica di Gastroenterologia SOS Epatopatie Croniche-Trapianto di Fegato Università Politecnica delle Marche, Ancona

2 Worldwide estimated new PLC cases and mortality (2012) Incidence 782,000 new PLCs worldwide 5th most common cancer in men (554,000 cases, 7.5% of total) and 9th in women (228,000 cases, 3.4%) Mortality 2nd most common cause of death from cancer worldwide, responsible for nearly 746,000 deaths HCC is the main cause of mortality in compensated cirrhosis Globocan, IARC 2012

3 Liver cancer 2016 Hepatocellular carcinoma (HCC) accounts for >90% of primary liver cancers. Liver cancer is the fifth most common cancer among men, the ninth most common cancer among women; Liver cancer is the second most common cause of cancer death for men and women combined; Ratio of mortality to incidence: 0.95 Ferlay et al., Int J Cancer 2015

4 Annual Report to the Nation on the Status of Cancer overall cancer incidence rates decreased 0.7%/year; death rates declined by 1.5%/year overall; deaths from liver cancer increased at the highest rate of all cancer sites for both sexes; CDC recommends a 1-time HCV test for persons born during 1945 through ACS, CDC, NCI, NAACCR Ryerson et al., Cancer 2016

5 Incidence rates of primary liver cancer according to geographical distribution in Europe EASL-EORTC CPG, J Hepatol 2012

6 Worldwide estimated new PLC cases and deaths Male Female Demographic risk factors: - male gender - geographic area Globocan, 2012 IARC

7 Rete AIRTUM COVERAGE: NORTH-WEST 41% NORTH-EAST 69% CENTRE 26% SOUTH/ISLAN DS 32% Copertura: 50% territorio nazionale

8 Primary Liver Cancer Italian epidemiological data From 1996 to 2014 incidence and mortality have shown a trend to slow progressive reduction Incidence:Mortality = 1.3 Males. Estimation of trends of cancer incidence ( ) and mortality ( ). Standardized rates to the European population. I-APC: : 0,9* ( 1,5; 0,4) M-APC: : 1,3 ( 2,1; 0,5) Incidence:Mortality = 1.0 Females. Estimation of trends of cancer incidence ( ) and mortality ( ). Standardized rates to the European population. I-APC: : 1.5 ( 0,7; 4,8) : -4,4* (-8,2; -0,5) M-APC: : 1,* ( 2,7; 0,8) APC = Annual Percent Change; I = Incidence; M = Mortality AIOM-CCM-AIRTUM, 2014

9 MORTALITY RATES FOR LIVER DISEASE POTENTIALLY CURED WITH LIVER TRANSPLANTATION AISF Libro Bianco dell Epatologia Italiana - Istituto Superiore di Sanità

10 Temporal trends of complications in patients with initially compensated cirhosis Child-Pugh class A patients (n = 312), median follow-up: 93 months - HCC is the most frequent complication - HCC is most frequently the first complication HCC Benvegnù et al. Gut 2004

11 The long-term outcome of HCV compensated cirrhosis: a 17-yr follow-up of 214 Pts Cumulative probability of events 100 Pts still at risk Annual Incidence rate HCC 3.9% Ascites 2.9% Jaundice 2.0% GI bleeding 0.7% EPS 0.1% HCC Ascites Jaundice GI bleeding EPS Years Sangiovanni A et al Hepatology 2006

12 Geographical distribution of risk factors >80% HCC associated with HBV or HCV

13 Annual risk of HCC in treated HBV patients Weighted mean annual incidence of HCC Entecavir Untreated Non-cirrhosis 0.7% 2.9% Cirrhosis 3.8% 5.0% Papatheodoridis GV et al., J Hepatol 2015; 62:

14 Irrespective of SVR achievement, all patients should continue surveillance because the risk of occurrence of HCC was not entirely avoided. Bruno S et al., Hepatology 2007; Cardoso AC et al., J Hepatol 2010; Morgan et al., Hepatology 2010; van der Meer AJ, JAMA 2012

15 Effects of Viral Eradication in Patients With Hepatitis C Virus and Cirrhosis Differ With Stage of Portal Hypertension 444 patients, 218 stage stage 2, mena follow-up 7.5 yrs HCC development Stage 1 (without EV) Stage 2 (with EV) 7 SVR patients, mean time 6.5 years, 87% BCLC-A 92 non-svr patients, mean time 4.7 years, 68% BCLC-A 2.9% year 0.7% year 3.6% year 0.9% year Di Marco et al., Gastroenterology 2016

16 Death or OLTx Effects of Viral Eradication in Patients With Hepatitis C Virus and Cirrhosis Differ With Stage of Portal Hypertension 444 patients, 218 stage stage 2, mena follow-up 7.5 yrs Di Marco et al., Gastroenterology 2016

17 Effects of Viral Eradication in Patients With Hepatitis C Virus and Cirrhosis Differ With Stage of Portal Hypertension 444 patients, 218 stage stage 2, mena follow-up 7.5 yrs Di Marco et al., Gastroenterology 2016

18 Survival of patients with HCV cirrhosis and sustained virologic response is similar to the general population (Bruno et al., J Hep 2016)

19 Risk factors of HCC >80% associated with HBV o HCV ( viral cancer) Pisani et al., Cancer Epidemiol Biomarkers Prev 1997 Western society HCC is becoming an addiction-environmental cancer: Drugs Alcohol Food Tobacco smoking Environmental contaminants

20 adulti HCC

21

22 ITAlian.LIver.CAncer network 2015 (since 1998): 6597 pts. GE MI Treviglio PR PI PD 1,2 BO 1,2,3,4 FI Roma 1,2 BZ Seriate Negrar Faenza VT NA 1,2 PA 1,2 AN 1. Benvegnù L. (PD) 2. Borzio F. (MI) 3. Cammà C. (PA) 4. Caturelli E. (VT) 5. Ciccarese F. (Treviglio) 6. Colecchia A (BO) 7. Di Marco M. (Seriate) 8. Farinati F. (PD) 9. Giannini E. (GE) 10. Masotto A. (Negrar) 11. Nardone G (NA) 12. Felder M. (BZ) 13. Foschi G.F. (Faenza) 14. Gasbarrini A. (Roma) 15. Missale G. (PR) 16. Morisco F. (NA) 17. Piscaglia F. (BO) 18. Rapaccini G.L. (Roma) 19. Sacco R. (PI) 20. Svegliati-Baroni G. (AN) 21. Trevisani F. (BO) 22. Virdone R. (PA) 23. Zoli M. (BO) Database ITA.LI.CA 2015

23 The changing scenario of hepatocellular carcinoma in the new century in Italy Patients (%) Mean age (±SD) years Total n n n n ± ± ± 10.6 <0.001 P HCC Cirrhosis Ageing Age (years) Bucci L et al., in revision Database ITA.LI.CA 2015

24 Percentage Etiology of HCC in Italy: observed and expected temporal trends 11 centers, 3027 patients, recruitment period Subject to PATH Program Disclaimer Santi V. et al., for ITA.LI.CA, J Hepatol 2012;56:

25 The changing scenario of hepatocellular carcinoma in the new century in Italy p < Viral Non viral Bucci L et al., in revision Database ITA.LI.CA 2015

26 Percentage Etiology of HCC: observed regional differences in Italy HCV prevalence ( ) 80 p<0.001 p< p= North Center South Bucci L et al., in revision Database ITA.LI.CA 2015

27 Percentage Etiology of HCC: observed regional differences in Italy HBV HCV Multietiology No viruses North Centre South Bucci L et al., in revision Database ITA.LI.CA 2015

28 Percentage The changing scenario of hepatocellular carcinoma in the new century in Italy HBV HCV Multietiology No viruses Bucci L et al., in revision Database ITA.LI.CA 2015

29 Percentage The changing scenario of hepatocellular carcinoma in the new century in Italy HBV HCV Multietiology No viruses Bucci L et al., in revision Database ITA.LI.CA 2015

30 Percentage Virus-free HCC in ITA.LI.CA: temporal trends in the new century Alcohol 10 NAFLD Multietiology Others Bucci L et al., in revision Database ITA.LI.CA 2015

31 Emerging protective factors for HCC: mediterranean diet Case-control study: 518 HCC vs 772 controls Report = lowest adherence to MD 9= highest adherence to MD Model adjusted for: center, age, sex, education, body mass index, smoking, diabetes, non-alcohol energy intake, and HBsAg and/or anti-hcv positivity. Turati F et al., J Hepatol 2015;60:606-11

32 Percentage (%) The changing scenario of hepatocellular carcinoma in the new century in Italy Total n n n n Cirrhosis 94.3% 94.6% 90.4% <0.001 P 100 Prevalence of cirrhosis by aetiology Viral p < Non viral Proportion of HCC patients with a non cirrhotic liver Bucci L et al., in revision Database ITA.LI.CA 2015

33

34 145 NAFLD-HCC vs 611 HCV-HCC from January 2010 to December 2012 Cirrhosis was detected in 78 of 145 NAFLD patients (53.8%)

35

36 Risk of HCC development in cirrhosis Social alcohol intake compared with no alcohol intake Ascha et al., Hepatology 2010

37 Percentage The changing scenario of hepatocellular carcinoma in the new century in Italy Percentage Type of diagnosis p = p <0.001 p <0.001 B 100 p <0.001 p = Surveillance interval 40 p = p = Surveillance Incidental Symptoms 40 p <0.001 Modality of HCC diagnosis 20 p = >13 Interval (months) Bucci L et al., in revision Database ITA.LI.CA 2015

38 % patients Surveillance for HCC by aetiology in ITA.LI.CA Percentage of cases diagnosed during regular surveillance 68% 37% 39% HCV n Alcohol n. 864 NASH/ Crypt. n. 271 Bucci L et al., in revision Database ITA.LI.CA 2015

39 Hepatocellular Carcinoma in Patients With Cryptogenic Cirrhosis Database ITA.LI.CA , 2042 HCC Giannini et al., CGH 2009

40 Hepatocellular Carcinoma in Patients With Cryptogenic Cirrhosis Database ITA.LI.CA , 2042 HCC HCV CC Giannini et al., CGH 2009

41

42

43 HCC Tumor Characterists: NAFLD vs HCV HCC on NAFLD n=145 HCC on HCV n=611 Crude mean overall survival NAFLD = 27.2 months HCV = 34.4 months (P = 0.015). Survival rates at 1 year and 3 years NAFLD = 76.4% and 48.7% HCV = 84.2% and 61.1% Piscaglia et al., Hepatology 2016

44 HCC Tumor Characterists: NAFLD vs HCV HCC on NAFLD n=145 HCC on HCV n=611 Mean overall survival lead time adjusted NAFLD = 25.5 months HCV = 33.7 months (P = 0.015). Survival rates at 1 year and 3 years NAFLD = 76.4% and 48.7% HCV = 84.2% and 61.1% Piscaglia et al., Hepatology 2016

45 HCC in NAFLD vs HCV after propensity score matching Mean overall survival NAFLD = 30.2 months HCV = 36.9 months (P = 0.33). Survival rates at 1 year and 3 years NAFLD = 87.4% and 72.6% HCV = 91.9% and 63.3% Mean overall survival of HCC on NAFLD NAFLD with cirrhosis = 28.5 m NAFLD without cirrhosis = 34.9 m (P = ns). No significant impact of cirrhosis Piscaglia et al., Hepatology 2016

46 HCC in NAFLD vs HCV: only Milan-in submitted to curative therapies Mean overall survival NAFLD = 38.6 months HCV = 41.0 months (P = ns). NAFLD HCC patients die more of non liver related causes than HCV HCC patients Piscaglia et al., Hepatology 2016

47 These results highlight the need to focus future research on identifying those patients with NAFLD who require surveillance in order to establish earlier diagnosis and offer them treatment, which in our series appeared to be as effective as that provided for patients with HCV at an early stage.

48 EASL CPG 2016 Screening for HCC-NAFLD

49 The changing scenario of hepatocellular carcinoma in the new century in Italy BCLC Total n P <0.001 Stage % 5.4% 7.9% ( ) Stage A % 37.2% 38.3% ( ) Stage B % 15.6% 14.9% ( ) Stage C % 30.8% 30.5% ( ) Stage D % 11.0% 8.4% Tumor size 4562 < cm % 30.1% 29.1% ( ) cm % 51.4% 48.1% ( ) > 5 cm % 18.5% 22.8% ( ) Database ITA.LI.CA 2015

50 Primary Liver Cancer Italian epidemiological data (AIRTUM 2015) 21% nel 2009

51 The changing scenario of hepatocellular carcinoma in the new century in Italy Survival probability (%) Survival probability (%) Overall survival at 5-yrs: 39.2% All patients (n. 5118) Viral patients (n. 3622) Non-viral patients (n. 1444) G1: median OS (95% CI) 30.7 ( ) G2: median OS (95% CI) 32.2 ( ) G3: median OS (95% CI) 40.4 ( ) G1: median OS (95% CI) 31.5 ( ) G2: median OS (95% CI) 33.2 ( ) G3: median OS (95% CI) 40.4 ( ) G1: median OS (95% CI) 24.8 ( ) G2: median OS (95% CI) 27.5 ( ) G3: median OS (95% CI) 35.3 ( ) p<0.001 p=0.001 p= BCLC 0+A (n.1884) G1: median OS (95% CI) 45.8 ( ) G2: median OS (95% CI) 57.5 ( ) G3: median OS (95% CI) nd BCLC B (n. 704) BCLC C (n. 1223) G1: median OS (95% CI) 20.8 ( ) G2: median OS (95% CI) 27.2 ( ) G3: median OS (95% CI) 30.6 ( ) G1: median OS (95% CI) 14.2 ( ) G2: median OS (95% CI) 17.5 ( ) G3: median OS (95% CI) 15.9 ( ) p<0.001 p=0.004 p= Bucci L et al., in revision Months Database ITA.LI.CA 2015

52 Epidemiology of HCC in ITALY: take home messages The incidence and mortality of HCC is decreasing, particularly in men. The etiologic scenario is changing, with a reduction in HCV-related tumors and a progressive rise of non-viral tumor, particularly of metabolic HCCs. The proportion of HCCs detected during a correct surveillance is moderately increasing, being this trend curbed by the spreading out of non-viral tumors. In clinical series, almost 50% of HCC are diagnosed at early stages, with an increase of very early tumors. Nevertheless, large tumors (>5 cm) are increasing. The treatment distribution and outcome are changed in all HCC stages, likely reflecting a more appropriate selection of candidates and technical refinements for each approach. Overall survival is improving both in viral and non-viral patients. However, in population-based registries the 5-year survival rate remains dismal.

53 Mr. ITA.LI.CA

Worldwide Causes of HCC

Worldwide Causes of HCC Approach to HCV Treatment in Patients with HCC JORGE L. HERRERA, MD, MACG UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE Worldwide Causes of HCC 60% 50% 40% 54% 30% 20% 10% 31% 15% 0% Hepatitis B Hepatitis

More information

Worldwide Causes of HCC

Worldwide Causes of HCC Approach to HCV Treatment in Patients with HCC Mark W. Russo, MD, MPH, FACG Carolinas HealthCare System Charlotte Worldwide Causes of HCC 60% 50% 40% 30% 20% 10% 0% 54% 31% 15% Hepatitis B Hepatitis C

More information

CIRROSI E IPERTENSIONE PORTALE NELLA DONNA

CIRROSI E IPERTENSIONE PORTALE NELLA DONNA Cagliari, 16 settembre 2017 CIRROSI E IPERTENSIONE PORTALE NELLA DONNA Vincenza Calvaruso, MD, PhD Ricercatore di Gastroenterologia Gastroenterologia & Epatologia, Di.Bi.M.I.S. Università degli Studi di

More information

Hepatocellular Carcinoma (HCC): Burden of Disease

Hepatocellular Carcinoma (HCC): Burden of Disease Hepatocellular Carcinoma (HCC): Burden of Disease Blaire E Burman, MD VM Hepatology Hepatocellular Carcinoma (HCC) Primary HCCs most often arise in the setting of chronic inflammation, liver damage, and

More information

Liver transplant: what is left after the viruses

Liver transplant: what is left after the viruses Riunione Monotematica A.I.S.F. 2016 The Future of Liver Disease: Beyond HCV is there a Role for Hepatologist? Milan 15 th 2016 Liver transplant: what is left after the viruses Stefano Ginanni Corradini

More information

Hepatocellular Carcinoma Surveillance

Hepatocellular Carcinoma Surveillance Amit G. Singal, MD, MS Hepatocellular Carcinoma Surveillance Postgraduate Course: Challenges in Management of Common Liver Diseases 308 1 Patient Case 69 year-old otherwise healthy male with compensated

More information

9th Paris Hepatitis Conference

9th Paris Hepatitis Conference 9th Paris Hepatitis Conference Paris, 12 January 2016 Treatment of hepatocellular carcinoma: beyond international guidelines Massimo Colombo Chairman Department of Liver, Kidney, Lung and Bone Marrow Units

More information

IS THERE A DIFFERENCE IN LIVER CANCER RATES IN PATIENTS WHO RECEIVE TREATMENT FOR HEPATITIS?

IS THERE A DIFFERENCE IN LIVER CANCER RATES IN PATIENTS WHO RECEIVE TREATMENT FOR HEPATITIS? IS THERE A DIFFERENCE IN LIVER CANCER RATES IN PATIENTS WHO RECEIVE TREATMENT FOR HEPATITIS? Dr. Sammy Saab David Geffen School of Medicine, Los Angeles, USA April 2018 DISCLAIMER Please note: The views

More information

Viral Hepatitis The Preventive Potential of Antiviral Therapy. Thomas Berg

Viral Hepatitis The Preventive Potential of Antiviral Therapy. Thomas Berg Viral Hepatitis The Preventive Potential of Antiviral Therapy Thomas Berg Therapeutic and preventive strategies in patients with hepatitis virus infection Treatment of acute infection Treatment of chronic

More information

Healthy Liver Cirrhosis

Healthy Liver Cirrhosis Gioacchino Angarano Clinica delle Malattie Infettive Università degli Studi di Foggia Healthy Liver Cirrhosis Storia naturale dell epatite HCVcorrelata in assenza di terapia Paestum 13-15 Maggio 24 The

More information

6 Riunione Monotematica A.I.S.F NASH malattia epatica, oncologica e cardiovascolare

6 Riunione Monotematica A.I.S.F NASH malattia epatica, oncologica e cardiovascolare 6 Riunione Monotematica A.I.S.F. 2015 NASH malattia epatica, oncologica e cardiovascolare Modena, 9 ottobre 2015 Massimo Colombo NAFLD e HCC: caratteristiche distintive Chairman Department of Liver, Kidney,

More information

Hepatocellular carcinoma

Hepatocellular carcinoma Hepatocellular carcinoma Mary Ann Y. Huang, M.D., M.S., FAASLD Transplant hepatologist Peak Gastroenterology Associates Porter Adventist Hospital Denver, Colorado Background - Worldwide Hepatocellular

More information

Hepatocellular Carcinoma: Can We Slow the Rising Incidence?

Hepatocellular Carcinoma: Can We Slow the Rising Incidence? Hepatocellular Carcinoma: Can We Slow the Rising Incidence? K.Rajender Reddy M.D. Professor of Medicine Director of Hepatology Medical Director of Liver Transplantation University of Pennsylvania Outline

More information

Life After SVR for Cirrhotic HCV

Life After SVR for Cirrhotic HCV Life After SVR for Cirrhotic HCV KIM NEWNHAM MN, NP CIRRHOSIS CARE CLINIC UNIVERSITY OF ALBERTA Objectives To review the benefits of HCV clearance in cirrhotic patients To review some of the emerging data

More information

3 Workshop on HCV THERAPY ADVANCES New Antivirals in Clinical Practice

3 Workshop on HCV THERAPY ADVANCES New Antivirals in Clinical Practice 3 Workshop on HCV THERAPY ADVANCES New Antivirals in Clinical Practice Rome, 13 December 2013 Management and monitoring of HCC in the future era of DAA s Prof. Massimo Colombo Chairman Department of Liver,

More information

Hepatocellular Carcinoma. Markus Heim Basel

Hepatocellular Carcinoma. Markus Heim Basel Hepatocellular Carcinoma Markus Heim Basel Outline 1. Epidemiology 2. Surveillance 3. (Diagnosis) 4. Staging 5. Treatment Epidemiology of HCC Worldwide, liver cancer is the sixth most common cancer (749

More information

Jose D Sollano, MD Professor of Medicine University of Santo Tomas Manila, Philippines. University of Santo Tomas

Jose D Sollano, MD Professor of Medicine University of Santo Tomas Manila, Philippines. University of Santo Tomas Jose D Sollano, MD Professor of Medicine Manila, Philippines International Variation in Age-Standardized Liver Cancer Incidence Rates in Both Sexes, 2008 Global Age-Standardized Liver Cancer Incidence

More information

White Nights of Hepatology 2016

White Nights of Hepatology 2016 White Nights of Hepatology 2016 Saint Petersburg, 3 June 2016 Long-term treatment of Chronic hepatitis B - a key to HCC prevention Massimo Colombo Chairman Department of Liver, Kidney, Lung and Bone Marrow

More information

Chronic viral hepatitis and liver disease in Belgium Pierre Deltenre

Chronic viral hepatitis and liver disease in Belgium Pierre Deltenre Chronic viral hepatitis and liver disease in Belgium Pierre Deltenre Brussels, November 7, 2017 Hepatitis B and C in Belgium What we need to know 1. Who is at risk of infection? 2. What is the natural

More information

Viral hepatitis and Hepatocellular Carcinoma

Viral hepatitis and Hepatocellular Carcinoma Viral hepatitis and Hepatocellular Carcinoma Hashem B. El-Serag, MD, MPH Dan L. Duncan Professor of Medicine Chief, Gastroenterology and Hepatology Houston VA & Baylor College of Medicine Houston, TX Outline

More information

Liver Cancer: Epidemiology and Health Disparities. Andrea Goldstein NP, MS, MPH Scientific Director Onyx Pharmaceuticals

Liver Cancer: Epidemiology and Health Disparities. Andrea Goldstein NP, MS, MPH Scientific Director Onyx Pharmaceuticals Liver Cancer: Epidemiology and Health Disparities Andrea Goldstein NP, MS, MPH Scientific Director Onyx Pharmaceuticals 1. Bosch FX, et al. Gastroenterology. 2004;127(5 suppl 1):S5-S16. 2. American Cancer

More information

HCC: Is it an oncological disease? - No

HCC: Is it an oncological disease? - No June 13-15, 2013 Berlin, Germany Prof. Oren Shibolet Head of the Liver Unit, Department of Gastroenterology Tel-Aviv Sourasky Medical Center and Tel-Aviv University HCC: Is it an oncological disease? -

More information

Screening for HCCwho,

Screening for HCCwho, Screening for HCCwho, how and how often? Catherine Stedman Associate Professor of Medicine, University of Otago, Christchurch Gastroenterology Department, Christchurch Hospital HCC Global Epidemiology

More information

Hepatitis Alert: Management of Patients With HCV Who Have Achieved SVR

Hepatitis Alert: Management of Patients With HCV Who Have Achieved SVR Hepatitis Alert: Management of Patients With HCV Who Have Achieved SVR This program is supported by educational grants from AbbVie, Gilead Sciences, and Merck About These Slides Please feel free to use,

More information

The impact of the treatment of HCV in developing Hepatocellular Carcinoma

The impact of the treatment of HCV in developing Hepatocellular Carcinoma The impact of the treatment of HCV in developing Hepatocellular Carcinoma Paul Y Kwo, MD Professor of Medicine Medical Director, Liver Transplantation Gastroenterology/Hepatology Division Indiana University

More information

B C Outlines. Child-Pugh scores

B C Outlines. Child-Pugh scores B C 2016-12-09 Outlines Child-Pugh scores CT MRI Fibroscan / ARFI Histologic Scoring Systems for Fibrosis Fibrosis METAVIR Ishak None 0 0 Portal fibrosis (some) 1 1 Portal fibrosis (most) 1 2 Bridging

More information

Hepatocellular Carcinoma in Qatar

Hepatocellular Carcinoma in Qatar Hepatocellular Carcinoma in Qatar K. I. Rasul 1, S. H. Al-Azawi 1, P. Chandra 2 1 NCCCR, 2 Medical Research Centre, Hamad Medical Corporation, Doha, Qatar Abstract Objective The main aim of this study

More information

Cirrhosis is different from Fibrosis

Cirrhosis is different from Fibrosis Riunione Monotematica AISF 2016 «The Future of Liver Disease: Beyond HCV is there a Role for Hepatologist» Milan 13 th -14 th 2016 Cirrhosis is different from Fibrosis I have not disclosures to declare

More information

Surveillance for Hepatocellular Carcinoma

Surveillance for Hepatocellular Carcinoma Surveillance for Hepatocellular Carcinoma Marion G. Peters, MD John V. Carbone, MD, Endowed Chair Professor of Medicine Chief of Hepatology Research University of California San Francisco Recorded on April

More information

HCV care after cure. This program is supported by educational grants from

HCV care after cure. This program is supported by educational grants from HCV care after cure This program is supported by educational grants from Raffaele Bruno,MD Department of Infectious Diseases, Hepatology Outpatients Unit University of Pavia Fondazione IRCCS Policlinico

More information

ANTIVIRAL THERAPY FOR HCV. Alfredo Alberti

ANTIVIRAL THERAPY FOR HCV. Alfredo Alberti CLINICAL IMPACT OF SVR AFTER ANTIVIRAL THERAPY FOR HCV Alfredo Alberti Department of Histology,Microbiology and Medical Biotechnologies Molecular Hepatology Unit Venetian Institute of Molecular Medicine

More information

Hepatitis B. What's the impact on the risk? Dr Himanshu Bhatia, Asia Chief Medical Officer ALUCA, Brisbane, Sept 2013

Hepatitis B. What's the impact on the risk? Dr Himanshu Bhatia, Asia Chief Medical Officer ALUCA, Brisbane, Sept 2013 Hepatitis B What's the impact on the risk? Dr Himanshu Bhatia, Asia Chief Medical Officer ALUCA, Brisbane, Sept 2013 Some quick facts about Hepatitis B Worldwide: 350-400 Million are chronic infections

More information

Management of Hepatocellular Carcinoma in Africa CWN Spearman

Management of Hepatocellular Carcinoma in Africa CWN Spearman Management of Hepatocellular Carcinoma in Africa CWN Spearman Division of Hepatology Department of Medicine Faculty of Health Sciences University of Cape Town Nothing to disclose Disclosures HCC in Africa

More information

Tumor incidence varies significantly, depending on geographical location.

Tumor incidence varies significantly, depending on geographical location. Hepatocellular carcinoma is the 5 th most common malignancy worldwide with male-to-female ratio 5:1 in Asia 2:1 in the United States Tumor incidence varies significantly, depending on geographical location.

More information

HEPATOCELLULAR CARCINOMA: SCREENING, DIAGNOSIS, AND TREATMENT

HEPATOCELLULAR CARCINOMA: SCREENING, DIAGNOSIS, AND TREATMENT HEPATOCELLULAR CARCINOMA: SCREENING, DIAGNOSIS, AND TREATMENT INTRODUCTION: Hepatocellular carcinoma (HCC): Fifth most common cancer worldwide Third most common cause of cancer mortality In Egypt: 2.3%

More information

Impatto della clearance virale e rischio di carcinoma epatocellulare

Impatto della clearance virale e rischio di carcinoma epatocellulare EPATITE CRONICA DA HCV: Impatto della clearance virale e rischio di carcinoma epatocellulare Rodolfo Sacco, M.D., PhD Direttore U.O.C. Gastroenterologia ed Endoscopia Digestiva A.O.U. Ospedali Riuniti"

More information

Antiviral Therapy and Liver Cancer

Antiviral Therapy and Liver Cancer Antiviral Therapy and Liver Cancer St. Petersburg, 070613 Markus Peck-Radosavljevic Gastroenterologie & Hepatologie AKH & Medizinische Universität Wien HCC Study Group Medizinische Universität Wien Prevention

More information

Hepatocellular Carcinoma: Epidemiology and Screening

Hepatocellular Carcinoma: Epidemiology and Screening Hepatocellular Carcinoma: Epidemiology and Screening W. Ray Kim, MD Professor and Chief Gastroenterology and Hepatology Stanford University School of Medicine Case A 67 year old Filipino-American woman

More information

La gestione corrente dell infezione cronica da HCV: la progressione verso la cirrosi. Simona Landonio I Div Mal inf H Sacco Milano

La gestione corrente dell infezione cronica da HCV: la progressione verso la cirrosi. Simona Landonio I Div Mal inf H Sacco Milano La gestione corrente dell infezione cronica da HCV: la progressione verso la cirrosi Simona Landonio I Div Mal inf H Sacco Milano HCV Natural History Viganò M et al Gastroenterology 27;133:835-842 Overall

More information

Liver resection for HCC

Liver resection for HCC 8 th LIVER INTEREST GROUP Annual Meeting Cape Town 2017 Liver resection for HCC Jose Ramos University of the Witwatersrand Donald Gordon Medical Centre The liver is almost unique in that treatment of the

More information

Discontinuation of Nucleotide or Nucleoside Analogue therapy for Chronic Hepatitis B infection

Discontinuation of Nucleotide or Nucleoside Analogue therapy for Chronic Hepatitis B infection Discontinuation of Nucleotide or Nucleoside Analogue therapy for Chronic Hepatitis B infection Dr Abid Suddle Institute of Liver Studies King s College Hospital Why consider discontinuation of NA therapy?

More information

Hepatitis C. Core slides

Hepatitis C. Core slides Hepatitis C Core slides This material was prepared by the Viral Hepatitis Prevention Board The slides (or subsets) can be reproduced for educational use only, with reference to the original source and

More information

Dr. David James PINATO MD MRCP (UK) MRes PhD

Dr. David James PINATO MD MRCP (UK) MRes PhD European HIV Hepatitis Co-infection (EHHC) Conference 10-11 December 2015, London Plenary Session 4: Hepatitis B L i v e r C a n c e r P a t h o g e n e s i s, S c r e e n i n g & Tr e a t m e n t Dr.

More information

Development of a prognostic scoring system for resectable hepatocellular carcinoma

Development of a prognostic scoring system for resectable hepatocellular carcinoma Submit a Manuscript: http://www.wjgnet.com/esps/ Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx DOI: 10.3748/wjg.v22.i36.8194 World J Gastroenterol 2016 September 28; 22(36): 8194-8202 ISSN 1007-9327

More information

Ultrasound screening for hepatocellular carcinoma in patients with advanced liver fibrosis. An overview.

Ultrasound screening for hepatocellular carcinoma in patients with advanced liver fibrosis. An overview. Review Med Ultrason 2014, Vol. 16, no. 2, 139-144 DOI: Ultrasound screening for hepatocellular carcinoma in patients with advanced liver fibrosis. An overview. Mirela Dănilă, Ioan Sporea Gastroenterology

More information

ORIGINAL ARTICLE LIVER TRANSPLANTATION 21: , Additional supporting information may be found in the online version of this article.

ORIGINAL ARTICLE LIVER TRANSPLANTATION 21: , Additional supporting information may be found in the online version of this article. LIVER TRANSPLANTATION 21:1250 1258, 2015 ORIGINAL ARTICLE Utility-Based Criteria for Selecting Patients With Hepatocellular Carcinoma for Liver Transplantation: A Multicenter Cohort Study Using the Alpha-Fetoprotein

More information

Alcoholic Liver Disease as First Indication

Alcoholic Liver Disease as First Indication Alcoholic Liver Disease as First Indication Patrizia Burra Multivisceral Transplant Unit Gastroenterology Department of Surgery, Oncology and Gastroenterology Padua University Hospital, Padua, Italy Patrizia

More information

HEPATOCELLULAR CARCINOMA: AN OVERVIEW

HEPATOCELLULAR CARCINOMA: AN OVERVIEW HEPATOCELLULAR CARCINOMA: AN OVERVIEW John K. Olynyk Head, Department of Gastroenterology & Hepatology Fiona Stanley Fremantle Hospital Group Dean of Research, Edith Cowan University RISING MORTALITY OF

More information

End Stage Liver Disease & Disease Specific Indications for Liver Transplant. Susan Kang, RN, MSN, ANP-BC

End Stage Liver Disease & Disease Specific Indications for Liver Transplant. Susan Kang, RN, MSN, ANP-BC End Stage Liver Disease & Disease Specific Indications for Liver Transplant Susan Kang, RN, MSN, ANP-BC Introduction (https://www.srtr.org) What does the liver do? STORAGE METABOLIC DETOXIFICATION SYNTHETIC

More information

End Stage Liver Disease & Disease Specific Indications for Liver Transplant Susan Kang, RN, MSN, ANP BC

End Stage Liver Disease & Disease Specific Indications for Liver Transplant Susan Kang, RN, MSN, ANP BC End Stage Liver Disease & Disease Specific Indications for Liver Transplant Susan Kang, RN, MSN, ANP BC Introduction (https://www.srtr.org) 1 What does the liver do? STORAGE METABOLIC DETOXIFICATION SYNTHETIC

More information

Hepatitis B Virus-Related Hepatocellular Carcinoma Presenting at an Advanced Stage: Is it Preventable? Dr Tom Mules NZSG ASM 2018

Hepatitis B Virus-Related Hepatocellular Carcinoma Presenting at an Advanced Stage: Is it Preventable? Dr Tom Mules NZSG ASM 2018 Hepatitis B Virus-Related Hepatocellular Carcinoma Presenting at an Advanced Stage: Is it Preventable? Dr Tom Mules NZSG ASM 2018 HCC Males Females Ferlay et al. Cancer incidence and mortality worldwide:

More information

Does Viral Cure Prevent HCC Development

Does Viral Cure Prevent HCC Development Does Viral Cure Prevent HCC Development Prof. Henry LY Chan Head, Division of Gastroenterology and Hepatology Director, Institute of Digestive Disease Director, Center for Liver Health Assistant Dean,

More information

Hepatitis, HIV and Malignancy

Hepatitis, HIV and Malignancy 11th International Workshop on Co-infection - HIV & Hepatitis London, June 11 th -12 th, 2015 Hepatitis, HIV and Malignancy Dr. David James PINATO MD MRCP (UK) MRes PhD NIHR Academic Clinical Lecturer

More information

DIFFERENTIAL BENEFITS OF DAAs IN DIFFERENT PATIENT POPULATIONS. IN PATIENTS ON A WAITING LIST FOR TRANSPLANTATION. THE CLINIC.

DIFFERENTIAL BENEFITS OF DAAs IN DIFFERENT PATIENT POPULATIONS. IN PATIENTS ON A WAITING LIST FOR TRANSPLANTATION. THE CLINIC. DIFFERENTIAL BENEFITS OF DAAs IN DIFFERENT PATIENT POPULATIONS. IN PATIENTS ON A WAITING LIST FOR TRANSPLANTATION. THE CLINIC. Robert J. de Knegt, Erasmus MC, Rotterdam r.deknegt@erasmusmc.nl Disclosures

More information

Steatosi epatica ed HCV

Steatosi epatica ed HCV Steatosi epatica ed HCV Malattie delle vie biliari ed Epatologia Rho, Auditorium Padri Oblati, 11 Novembre 2006 Piero L. Almasio Università di Palermo HISTOPATHOLOGY Steatosis and accelerated fibrogenesis:

More information

Dr. Siddharth Srivastava

Dr. Siddharth Srivastava Dr. Siddharth Srivastava MD, DM (Gastroenterology) Associate Professor GIPMER, New Delhi Rashtriya Gaurav Award 2013 for work on hepatitis B and C Set up Liver clinic at GIPMER and in charge EUS laboratory.

More information

Management of HepatoCellular Carcinoma

Management of HepatoCellular Carcinoma 9th Symposium GIC St Louis - 2010 Management of HepatoCellular Carcinoma Overview Pierre A. Clavien, MD, PhD Department of Surgery University Hospital Zurich Zurich, Switzerland Hepatocellular carcinoma

More information

Prognostic Features, Treatment Outcomes and Survival of Hepatocellular Carcinoma Patients in National Kidney and Transplant Institute

Prognostic Features, Treatment Outcomes and Survival of Hepatocellular Carcinoma Patients in National Kidney and Transplant Institute Philippine Journal of Internal Medicine Original Paper Prognostic Features, Treatment Outcomes and Survival of Hepatocellular Carcinoma Patients in National Kidney and Transplant Institute Rei Joseph Prieto,

More information

The Impact of DAA on HCC Occurrence

The Impact of DAA on HCC Occurrence The Impact of DAA on HCC Occurrence Professeur Didier Samuel Centre Hépatobiliaire Inserm-Paris Sud Research Unit 1193 Departement Hospitalo Universitaire Hepatinov Hôpital Paul Brousse Université Paris

More information

Hepatitis C Update on New Treatments

Hepatitis C Update on New Treatments Hepatitis C Update on New Treatments Kevork M. Peltekian, MD, FRCPC 44th Annual Dalhousie Spring Refresher Course - Therapeutics April 5 - April 7, 2018 Halifax Convention Centre Disclosures Conflicts

More information

Successful hepatitis C treatment lowers risk of death for people with HIV and HCV co infection

Successful hepatitis C treatment lowers risk of death for people with HIV and HCV co infection Successful hepatitis C treatment lowers risk of death for people with HIV and HCV co infection Liz Highleyman Produced in collaboration with hivandhepatitis.com Published: 28 October 2015 Jump to Trends

More information

Hepatitis C Virus and Metabolism

Hepatitis C Virus and Metabolism AISF Annual Meeting Roma, 23-24 Febbraio 2017 Hepatitis C Virus and Metabolism Salvatore Petta Sezione di Gastroenterologia, Di.Bi.M.I.S., University of Palermo, Italy salvatore.petta@unipa.it Salvatore

More information

蕾莎瓦 Nexavar 臨床試驗資料 (HCC 肝細胞癌 )

蕾莎瓦 Nexavar 臨床試驗資料 (HCC 肝細胞癌 ) 蕾莎瓦 Nexavar 臨床試驗資料 (HCC 肝細胞癌 ) 1 Sorafenib Improves Survival in Hepatocellular Carcinoma: Results of a Phase III Randomized, -Controlled Trial Josep M. Llovet, Sergio Ricci, Vincenzo Mazzaferro, Philip

More information

Risk Factors and Preventive Measures for Hepatocellular carcinoma (HCC) 울산의대울산대병원소화기내과박능화

Risk Factors and Preventive Measures for Hepatocellular carcinoma (HCC) 울산의대울산대병원소화기내과박능화 Risk Factors and Preventive Measures for Hepatocellular carcinoma (HCC) 울산의대울산대병원소화기내과박능화 Risk factors for HCC development (I) Environmental factors Infectious HBV HCV HDV Alimentary Alcohol Diet High

More information

Global Reporting System for Hepatitis (GRSH) An introduction. WHO Global Hepatitis Programme

Global Reporting System for Hepatitis (GRSH) An introduction. WHO Global Hepatitis Programme Global Reporting System for Hepatitis (GRSH) An introduction WHO Global Hepatitis Programme 2018 Objectives 1. Explain the role of the new reporting system 2. Outline the reporting required from countries

More information

AASLD Washington DC, USA Dr. Alexander Kim Chief Vascular and Interventional Radiology, Medstar Georgetown University Hospital

AASLD Washington DC, USA Dr. Alexander Kim Chief Vascular and Interventional Radiology, Medstar Georgetown University Hospital AASLD 2017 - Washington DC, USA Dr. Alexander Kim Chief Vascular and Interventional Radiology, Medstar Georgetown University Hospital THE CHANGING LANDSCAPE IN THE TREATMENT OF HCC DISCLAIMER Please note:

More information

The Impact of HBV Therapy on Fibrosis and Cirrhosis

The Impact of HBV Therapy on Fibrosis and Cirrhosis The Impact of HBV Therapy on Fibrosis and Cirrhosis Jordan J. Feld, MD, MPH Associate Professor of Medicine University of Toronto Hepatologist Toronto Centre for Liver Disease Sandra Rotman Centre for

More information

Hepatology. The critical issue of hepatocellular carcinoma restaging: which is the best tool available?

Hepatology. The critical issue of hepatocellular carcinoma restaging: which is the best tool available? The critical issue of hepatocellular carcinoma restaging: which is the best tool available? Journal: Manuscript ID HEP-- Wiley - Manuscript type: Rapid Communication Date Submitted by the Author: -Dec-0

More information

Transient elastography in chronic viral liver diseases

Transient elastography in chronic viral liver diseases 4 th AISF POST-MEETING COURSE Roma, 26 Febbraio 2011 Transient elastography in chronic viral liver diseases CRISTINA RIGAMONTI, M.D., Ph.D. Transient elastography (TE): a rapid, non-invasive technique

More information

Jong Young Choi, M.D.

Jong Young Choi, M.D. The Liver Week 2014 Jong Young Choi, M.D. Dept. of Internal Medicine The Catholic University of Korea, College of Medicine The clinical study for natural history of LC is not many. Most of them was done

More information

PROGRAMME AT A GLANCE

PROGRAMME AT A GLANCE PROGRAMME AT A GLANCE Hotel Hyatt Andaz Hotel Pullman Date Hall-H1 Hall-H2 Hall-P1 Hall-P2 Hall-P3 Hall-P4 Hall-P5 Hall-P6 Basic science workshop 1 Basic Science Workshop 2 Postgraduate Course - Liver

More information

Unmet needs in intermediate HCC. Korea University Guro Hospital Ji Hoon Kim

Unmet needs in intermediate HCC. Korea University Guro Hospital Ji Hoon Kim Unmet needs in intermediate HCC Korea University Guro Hospital Ji Hoon Kim BCLC HCC Stage 0 PST 0, Child Pugh A Stage A C PST 0 2, Child Pugh A B Stage D PST > 2, Child Pugh C Very early stage (0) 1 HCC

More information

EASL-EORTC Guidelines

EASL-EORTC Guidelines Pamplona, junio de 2008 CLINICAL PRACTICE GUIDELINES: PARADIGMS IN MANAGEMENT OF HCC EASL-EORTC Guidelines Bruno Sangro Clínica Universidad de Navarra. CIBERehd. Pamplona, Spain Levels of Evidence according

More information

Personalizzazione della Cura in Epatologia. Epatite Cronica C: Pazienti con Genotipo 2

Personalizzazione della Cura in Epatologia. Epatite Cronica C: Pazienti con Genotipo 2 Monotematica AISF 213 Personalizzazione della Cura in Epatologia Pisa, 17-19 Ottobre 213 Epatite Cronica C: Pazienti con Genotipo 2 Maria Grazia Rumi U.O. Epatologia, Ospedale San Giuseppe Università degli

More information

Hepatitis B and D Update on clinical aspects

Hepatitis B and D Update on clinical aspects Hepatitis B and D Update on clinical aspects B. Müllhaupt Gastroenterology and Hepatology Swiss Transplant and HPB-Center University Hospital Zurich beat.muellhaupt@usz.ch B.M. 11.11.17 Hepatitis Strategy

More information

Treatment of HCC in real life-chinese perspective

Treatment of HCC in real life-chinese perspective Treatment of HCC in real life-chinese perspective George Lau MBBS (HK), MRCP(UK), FHKCP, FHKAM (GI), MD(HK), FRCP (Edin, Lond), FAASLD (US) Chairman Humanity and Health Medical Group, Hong Kong SAR, CHINA

More information

Ari Bunim, M.D. Director of Hepatology New York Hospital Queens Assistant Professor of Clinical Medicine Weill Cornell Medical College

Ari Bunim, M.D. Director of Hepatology New York Hospital Queens Assistant Professor of Clinical Medicine Weill Cornell Medical College Ari Bunim, M.D. Director of Hepatology New York Hospital Queens Assistant Professor of Clinical Medicine Weill Cornell Medical College New York State Law Goes into Effect January 1, 2014 Hepatitis C Virus

More information

Surveillance for HCC Who, how Diagnosis of HCC Surveillance for HCC in Practice

Surveillance for HCC Who, how Diagnosis of HCC Surveillance for HCC in Practice Surveillance for Hepatocellular Carcinoma Hashem B. El-Serag, MD, MPH Dan L. Duncan Professor of Medicine Chief, Gastroenterology and Hepatology Houston VA & Baylor College of Medicine Houston, TX Outline

More information

Are we adequately screening at-risk patients for hepatocellular carcinoma in the outpatient setting?

Are we adequately screening at-risk patients for hepatocellular carcinoma in the outpatient setting? Rajani Sharma, PGY1 Geriatrics CRC Project, 12/19/13 Are we adequately screening at-risk patients for hepatocellular carcinoma in the outpatient setting? A. Study Purpose and Rationale Hepatocellular carcinoma

More information

The place of bariatric surgery in NASH: can we extend the indications? - No

The place of bariatric surgery in NASH: can we extend the indications? - No The place of bariatric surgery in NASH: can we extend the indications? - No Nicolas Goossens Service de Gastroentérologie & Hépatologie Hôpitaux Universitaires de Genève Genève, Suisse How to extend the

More information

Hepatocellular carcinoma in Sri Lanka - where do we stand?

Hepatocellular carcinoma in Sri Lanka - where do we stand? SCIENTIFIC ARTICLE Hepatocellular carcinoma in Sri Lanka - where do we stand? R.C. Siriwardana 1, C.A.H. Liyanage 1, M.B. Gunethileke 2 1. Specialist Gastrointestinal and Hepatobilliary Surgeon, Senior

More information

STOP Hepatocellular Carcinoma

STOP Hepatocellular Carcinoma STOP Hepatocellular Carcinoma Laura Tenner MD MPH, Amit G. Singal MD MS, Mamta Jain MD, Barbara Turner MD, Barbara Riske MS ReACH Center and Dept of Medicine UT Health San Antonio Dept of Medicine UT Southwestern

More information

An Update HBV Treatment

An Update HBV Treatment An Update HBV Treatment Epidemiology Natural history Treatment Daryl T.-Y. Lau, MD, MPH Associate Professor of Medicine Director of Translational Liver Research Division of Gastroenterology BIDMC, Harvard

More information

Long-term Clinical Outcomes and Risk of Hepatocellular Carcinoma in Chronic Hepatitis B Patients with HBsAg Seroclearance

Long-term Clinical Outcomes and Risk of Hepatocellular Carcinoma in Chronic Hepatitis B Patients with HBsAg Seroclearance Long-term Clinical Outcomes and Risk of Hepatocellular Carcinoma in Chronic Hepatitis B Patients with HBsAg Seroclearance Gi-Ae Kim, Han Chu Lee *, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim,

More information

DENOMINATOR: All patients aged 18 years and older with a diagnosis of chronic hepatitis C cirrhosis

DENOMINATOR: All patients aged 18 years and older with a diagnosis of chronic hepatitis C cirrhosis Quality ID #401: Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with Cirrhosis National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY

More information

Diagnosi e management non invasivo dell epatite cronica da HCV

Diagnosi e management non invasivo dell epatite cronica da HCV Diagnosi e management non invasivo dell epatite cronica da HCV Giovanni Squadrito Clinical and Molecular Hepatology University of Messina gsquadrito@unime.it Outline Diagnosis of HCV Non invasive tools

More information

3/22/2017. I will be discussing off label/investigational use of tivantinib for hepatocellular carcinoma.

3/22/2017. I will be discussing off label/investigational use of tivantinib for hepatocellular carcinoma. Grant/Research Support - AbbVie, Conatus, Hologic, Intercept, Genfit, Gilead, Mallinckrodt, Merck, Salix, Shire, Vital Therapies Consultant AbbVie, Gilead, Merck Member, Scientific Advisory Board Vital

More information

Liver Cancer Causes, Risk Factors, and Prevention

Liver Cancer Causes, Risk Factors, and Prevention Liver Cancer Causes, Risk Factors, and Prevention Risk Factors A risk factor is anything that affects your chance of getting a disease such as cancer. Learn more about the risk factors for liver cancer.

More information

Clinical Management of Hepatitis B WAN-CHENG CHOW DEPARTMENT OF GASTROENTEROLOGY & HEPATOLOGY SINGAPORE GENERAL HOSPITAL

Clinical Management of Hepatitis B WAN-CHENG CHOW DEPARTMENT OF GASTROENTEROLOGY & HEPATOLOGY SINGAPORE GENERAL HOSPITAL Clinical Management of Hepatitis B WAN-CHENG CHOW DEPARTMENT OF GASTROENTEROLOGY & HEPATOLOGY SINGAPORE GENERAL HOSPITAL The World Health Organisation recent initiatives on HBV infection Launching of the

More information

Association between Traditional Chinese Medicine Use and Liver Cancer in Patients with Liver Cirrhosis: A Population-based Study

Association between Traditional Chinese Medicine Use and Liver Cancer in Patients with Liver Cirrhosis: A Population-based Study Research Article imedpub Journals http://www.imedpub.com/ Journal of Cancer Epidemiology and Prevention Association between Traditional Chinese Medicine Use and Liver Cancer in Patients with Liver Cirrhosis:

More information

Surgical management of HCC. Evangelos Prassas Hepatobiliary and Pancreatic Surgery / Liver Transplantation Kings College Hospital / London

Surgical management of HCC. Evangelos Prassas Hepatobiliary and Pancreatic Surgery / Liver Transplantation Kings College Hospital / London Surgical management of HCC Evangelos Prassas Hepatobiliary and Pancreatic Surgery / Liver Transplantation Kings College Hospital / London Global distribution of HCC and staging systems WEST 1. Italy (Milan,

More information

Modelling the Impact of Interventions Targeting High- Risk Populations on the HCV Epidemic in Resource- Limited Settings Pakistan as a Case Study

Modelling the Impact of Interventions Targeting High- Risk Populations on the HCV Epidemic in Resource- Limited Settings Pakistan as a Case Study 1 Modelling the Impact of Interventions Targeting High- Risk Populations on the HCV Epidemic in Resource- Limited Settings Pakistan as a Case Study Aaron G. Lim, Matthew Hickman, Peter Vickerman Population

More information

HEPATITIS C VIRUS (HCV) GENOTYPE TESTING

HEPATITIS C VIRUS (HCV) GENOTYPE TESTING CLINICAL GUIDELINES For use with the UnitedHealthcare Laboratory Benefit Management Program, administered by BeaconLBS HEPATITIS C VIRUS (HCV) GENOTYPE TESTING Policy Number: PDS - 027 Effective Date:

More information

The Changing World of Hepatitis C

The Changing World of Hepatitis C The Changing World of Hepatitis C Alnoor Ramji Gastroenterology & Hepatology Clinical Associate Professor Division of Gastroenterology University Of British Columbia St. Paul s Hospital Site Disclosures

More information

Viral Hepatitis. Dr Melissa Haines Gastroenterologist Waikato Hospital

Viral Hepatitis. Dr Melissa Haines Gastroenterologist Waikato Hospital Viral Hepatitis Dr Melissa Haines Gastroenterologist Waikato Hospital Viral Hepatitis HAV HBV HCV HDV HEV Other viral: CMV, EBV, HSV Unknown Hepatitis A Hepatitis A Transmitted via the faecal-oral route

More information

The Chronic Liver Disease Foundation (CLDF) and the International Coalition of Hepatology Education Providers (IC-HEP) present:

The Chronic Liver Disease Foundation (CLDF) and the International Coalition of Hepatology Education Providers (IC-HEP) present: The Chronic Liver Disease Foundation (CLDF) and the International Coalition of Hepatology Education Providers (IC-HEP) present: Certified by: Provided by: Endorsed by: Hepatocellular Carcinoma HCC: Age

More information

HCV elimination : lessons from Scotland

HCV elimination : lessons from Scotland HCV elimination : lessons from Scotland Sharon Hutchinson Glasgow Caledonian University / Health Protection Scotland BHIVA Hepatology Highlights, Edinburgh, 17 th April 2018 Disclosures Honoraria from

More information

Sharing the Message of Hepatitis C and Liver Cancer in Indian Country

Sharing the Message of Hepatitis C and Liver Cancer in Indian Country Sharing the Message of Hepatitis C and Liver Cancer in Indian Country Jessica Leston, DrPH (c), MPH Northwest Portland Area Indian Health Board Clinical Programs Director - HIV/HCV Objectives Describe

More information

«Εκτίμηση κινδφνου ανάπτυξης ΗΚΚ σε ασθενείς με HCV λοίμωξη» Evaluation of HCC risk in HCV patients

«Εκτίμηση κινδφνου ανάπτυξης ΗΚΚ σε ασθενείς με HCV λοίμωξη» Evaluation of HCC risk in HCV patients «Εκτίμηση κινδφνου ανάπτυξης ΗΚΚ σε ασθενείς με HCV λοίμωξη» Evaluation of HCC risk in HCV patients Δημήτρησ Ν. αμωνάκησ Γαςτρεντερολογική κλινική Πανεπιςτημίου Κρήτησ Outline Epidemiology Risk factors

More information