Hepatocellular Carcinoma
|
|
- Lesley Strickland
- 6 years ago
- Views:
Transcription
1 PSH Clinical Guidelines Statement 2017 Hepatocellular Carcinoma Dr. Zia ud Din Associate professor of medicine Lady Reading Hospital Peshawar INTRODUCTION Hepatocellular carcinoma is the primary liver cancer and is major health problem. It is the 3 rd cause of cancer related death and accounts for 7percent of all cancers. 1 The incidence of HCC increases with advancing age and peaks at 70 years age. Males are more affected as compared to females; with male to female ratio estimated to be 2.4 2,3. It has the largest incidence in East Asia and Subsaharan Africa. 4 ETIOLOGICAL AND RISK FACTORS The most common underlying risk elements include chronic hepatitis B and C, alcohol intake and exposure to alfatoxin. 5 Cirrhosis is an important causative factor and maybe caused by chronic viral hepatitis, alcohol, non alcohol fatty liver disease and metabolic diseases like hemochromatosis or alpha1 antitrypsin deficiency. Approximately 1/3 rd of the cirrhotic patient will develop HCC during the lifetime. 6,7 Diabetes mellitus,cigarette smoking, obesity, HIV infectivity and fatty liver diseases have been linked to the development of HCC. 8,9 DIAGNOSIS Diagnosis of HCC is based on non-invasive criteria or pathology. Early HCC diagnosis is possible in 30 to 60 % of cases. 10,11 Non invasive criteria are accurate for the diagnosis of HCC with specificity of 100% and is based on a combination of imaging and laboratory findings. 12,13 Different imaging modalities are nowadays available such as ultrasound scan,4-phasic multidimensional CT scan, dynamic contrast-enhanced MRI. 14 Diagnosis is based on the identification of typical hallmark of HCC i,e, contrast uptake in the arterial phases and washout in the venous late phase PATHOLOGICAL DIAGNOSIS AFP is the most widely tested biomarker in HCC. AFP levels above 400 ng/ ml are considered as diagnostic. 18 Other serological tests of early HCC includes des-gammacarboxy prothrombin [DCP] and tissue marker GPC3. 19 Sensitivity of liver biopsy depends upon location, size and expertise. It has some limitations due to complications such as bleeding and needle tract seeding. 20 STAGGING SYSTEM Main prognostic variables are tumor stage, liver function and performance status. 21 BCLC [Barcelona Clinic Liver Cancer] is recommended for prognostic prediction and
2 treatment allocation. This classification divides HCC into 5 stages: 1. BCLC Stage 0 {Very Early HCC} is defined as the presence of single tumor less than 2cm without vascular invasion in patient with good health status BCLC Stage A [Early HCC} is defined as the presence of tumor greater than 2cm or presence of 3 nodules less than 3cm of diameter in patient with child-pugh A or B BCLC Stage B [Intermediate HCC] multinodular, asymptomatic tumor without an invasive pattern BCLC Stage C [Advanced HCC] symptomatic tumor with macro vascular invasion or extra hepatic spread BCLC Stage D [End-stage HCC] are characterized by presenting with tumors leading to very poor health performance and severe tumor related disability. 26 TREATMENT Treatment is based on the BCLC allocation system: RESECTION is the first line treatment option in patients with solitary tumor and well preserved liver functions, it is also indicated in patient with multifocal tumor [less than 3 nodules less than 3cm]. Tumor recurrence is the major complication of resection. 27,28 LIVER TRANSPLANTATION is considered to the first line treatment for patients with single tumor less than 5cm or less than 3 nodules less than 3cm not suitable for resection. Living donor liver transplantation is an alternative option in patient with a waiting list exceeding 6 to 7 months. 29,30 LOCAL ABLATION with radiofrequency or percutaneous ethanol injection is the standard therapy for patient with BCLC 0 - A tumors not suitable for surgery. 31 CHEMO EMBOLISATION is recommended for patient with BCLC Stage B, multinodular asymptomatic tumor without vascular invasion or extra hepatic spread. it is contraindicated in decompensated liver diseases, macroscopic invasion or extra hepatic spread. 32,33 SYSTEMIC THERAPY: Sorafenib is indicated in patient with well preserved liver function [CHILD- PUGH A CLASS] and with advanced tumors [BCLC C]. 34,35 Patient at BCLC-D needs palliative support, which includes pain management, nutritional and psychological support. PREVENTION Vaccination against hepatitis c is recommended to all newborns and to high-risk groups. In patient with chronic hepatitis, antiviral therapy leading to maintained HBV suppression in chronic hepatitis B and SVR in hepatitis C are recommended, since they have been showed to prevent progression to cirrhosis and hence HCC development. 36
3 REFRENCES 1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, CA Cancer J Clin 2005;55: [2] National Cancer Institute. PDQ levels of evidence for adult and pediatric cancer treatment studies. Bethesda, MD: National Cancer Institute. Date last modified 26/August/2010. ; 2011 [accessed ]. 2. El-Serag HB, Mason AC. Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med 1999;340: Trichopoulos D, Bamia C, Lagiou P, Fedirko V, Trepo E, Jenab M, et al. Hepatocellular carcinoma risk factors and disease burden in a European cohort: a nested case control study. J Natl Cancer Inst 2011;103: Bosetti C, Boffetta P, Lucchini F, Negri E, La Vecchia C. Trends in mortality from hepatocellular carcinoma in Europe, Hepatology 2008;48: Chang MH, You SL, Chen CJ, Liu CJ, Lee CM, Lin SM, et al. Taiwan Hepatoma Study Group. Decreased incidence of hepatocellular carcinoma in hepatitis B vaccinees: a 20- year follow-up study. J Natl Cancer Inst 2009;101: Ioannou G, Splan M, Weiss N, McDonald G, Beretta L, Lee S. Incidence and predictors of hepatocellular carcinoma in patients with cirrhosis. Clin Gastroenterol Hepatol 2007;5: El-Serag HB, Richardson PA, Everhart JE. The role of diabetes in hepatocellular carcinoma: a case control study among United States Veterans. Am J Gastroenterol 2001;96: Marrero J, Fontana R, Fu S, Conjeevaram H, Su G, Lok A. Alcohol, tobacco and obesity are synergistic risk factors for hepatocellular carcinoma. J Hepatol 2005;42: Chen CJ, Yang HI, Su J, Jen CL, You SL, Lu SN, et al. REVEAL-HBV Study Group. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA 2006;295: Yu MW, Yeh SH, Chen PJ, Liaw YF, Lin CL, Liu CJ, et al. Hepatitis B virus genotype and DNA level and hepatocellular carcinoma: a prospective study in men. J Natl Cancer Inst 2005;97: Masuzaki R, Tateishi R, Yoshida H, Goto E, Sato T, Ohki T. Prospective risk assessment for hepatocellular carcinoma development in patients with chronic hepatitis C by transient elastography. Hepatology 2009;49: Jung KS, Kim SU, Ahn SH, Park YN, Kim do Y, Park JY, et al. Risk assessment of hepatitis B virus-related hepatocellular carcinoma development using liver stiffness measurement (FibroScan). Hepatology 2011;53: Yu NC, Chaudhari V, Raman SS, Lassman C, Tong MJ, Busuttil RW, et al. CT and MRI improve detection of hepatocellular carcinoma, compared with ultrasound alone, in patients with cirrhosis. Clin Gastroenterol Hepatol 2011;9:
4 14. Sangiovanni A, Manini MA, Iavarone M, Romeo R, Forzenigo LV, Fraquelli M, et al. The diagnostic and economic impact of contrast imaging techniques in the diagnosis of small hepatocellular carcinoma in cirrhosis. Gut 2010;59: JOURNAL OF HEPATOLOGY Journal of Hepatology 2012 vol. 56 j Sersté T, Barrau V, Ozenne V, Vullierme MP, Bedossa P, Farges O, et al. Accuracy and disagreement of CT and MRI for the diagnosis of small hepatocellular carcinoma and dysplastic nodules: role of biopsy. Hepatology doi: /hep.24746, [Epub ahead of print]. 16. Rimola J, Forner A, Reig M, Vilana R, de Lope CR, Ayuso C, et al. Cholangiocarcinoma in cirrhosis: absence of contrast washout in delayed phases by magnetic resonance imaging avoids misdiagnosis of hepatocellular carcinoma. Hepatology 2009;50: Lencioni R, Cioni D, Della Pina C, Crocetti L, Bartolozzi C. Imaging diagnosis. Semin Liver Dis 2005;25: [115] International Consensus Group for Hepatocellular Neoplasia. Pathologic diagnosis of early hepatocellular carcinoma: a report of the international consensus group for hepatocellular neoplasia. Hepatology 2009;49: Di Tommaso L, Franchi G, Park YN, Fiamengo B, Destro A, Morenghi E, et al. Diagnostic value of HSP70, glypican 3, and glutamine synthetase in hepatocellular nodules in cirrhosis. Hepatology 2007;45: Silva MA, Hegab B, Hyde C, Guo B, Buckels JA, Mirza DF. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut 2008;57: Bolondi L, Gaiani S, Celli N, Golfieri R, Grigioni WF, Leoni S, et al. Characterization of small nodules in cirrhosis by assessment of vascularity: the problem of hypovascular hepatocellular carcinoma. Hepatology 2005;42: Kudo M. Review of 4th Single Topic Conference on HCC. Hepatocellular carcinoma: international consensus and controversies. Hepatol Res 2007;37:S83 S Llovet JM, Bruix J. Novel advancements in the management of hepatocellular carcinoma in J Hepatol 2008;48:S20 S Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology 2003;37: Cabibbo G, Enea M, Attanasio M, Bruix J, Craxì A, Cammà C. A meta-analysis of survival rates of untreated patients in randomized clinical trials of hepatocellular carcinoma. Hepatology 2010;51: Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 1999;19: Llovet JM, Schwartz M, Mazzaferro V. Resection and liver transplantation for hepatocellular carcinoma. Semin Liver Dis 2005;25: Mazzaferro V, Bhoori S, Sposito C, Bongini M, Langer M, Miceli R, et al. Milan criteria in liver transplantation for HCC: an evidence-based analysis on 15 years of experience. Liver Transpl 2011;17:S44 S57.
5 28. Iwatsuki S, Starzl TE, Sheahan DG, Yokoyama I, Demetris AJ, Todo S, et al. Hepatic resection versus transplantation for hepatocellular carcinoma. Ann Surg 1991;214: Iwatsuki S, Esquivel CO, Gordon RD, Shaw Jr BW, Starzl TE, Shade RR, et al. Liver transplantation for fulminant hepatic failure. Semin Liver Dis 1985;5: Lencioni R. Loco-regional treatment of hepatocellular carcinoma. Hepatology 2010;52: Takayasu K, Arii S, Ikai I, Omata M, Okita K, Ichida T, et al. Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology 2006;131: Ikai I, Arii S, Kojiro M, Ichida T, Makuuchi M, Matsuyama Y, et al. Reevaluation of prognostic factors for survival after liver resection in patients with hepatocellular carcinoma in a Japanese nationwide survey. Cancer 2004;101: Llovet JM, Bruix J, Fuster J, Castells A, García-Valdecasas JC, Grande L, et al. Liver transplantation for treatment of small hepatocellular carcinoma: the TNM classification does not have prognostic power. Hepatology 1998;27: Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, et al. SHARP Investigators Study Group. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008;359: Chang MH, You SL, Chen CJ, Liu CJ, Lee CM, Lin SM, et al. Taiwan Hepatoma Study Group. Decreased incidence of hepatocellular carcinoma in hepatitis B vaccinees: a 20- year follow-up study. J Natl Cancer Inst 2009;101:
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 informationLiver transplantation: Hepatocellular carcinoma
Liver transplantation: Hepatocellular carcinoma Alejandro Forner BCLC Group. Liver Unit. Hospital Clínic. University of Barcelona 18 de marzo 2015 3r Curso Práctico de Transplante de Órganos Sólidos Barcelona
More informationHepatocellular 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 informationIS 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 informationThe 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 informationHEPATOCELLULAR 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 informationLiver 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 informationTumor 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 informationHepatocellular Carcinoma HCC Updated November 2015 by: Dr. Mohammed Alghamdi (Medical Oncology Fellow, University of Calgary)
Hepatocellular Carcinoma HCC Updated November 2015 by: Dr. Mohammed Alghamdi (Medical Oncology Fellow, University of Calgary) Staff Reviewers: Dr. Yoo Joung Ko (Medical Oncologist, Sunnybrook Odette Cancer
More informationSurveillance 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 informationHepatocellular 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 informationEASL-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 informationAre 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 informationManagement 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 informationHepatocellular Carcinoma (HCC): Who Should be Screened and How Do We Treat? Tom Vorpahl MSN, RN, ACNP-BC
Hepatocellular Carcinoma (HCC): Who Should be Screened and How Do We Treat? Tom Vorpahl MSN, RN, ACNP-BC Objectives Identify patient risk factors for hepatocellular carcinoma (HCC) Describe strategies
More informationHepatocellular Carcinoma: Diagnosis and Management
Hepatocellular Carcinoma: Diagnosis and Management Nizar A. Mukhtar, MD Co-director, SMC Liver Tumor Board April 30, 2016 1 Objectives Review screening/surveillance guidelines Discuss diagnostic algorithm
More informationHepatocellular Carcinoma (HCC)
Title Slide Hepatocellular Carcinoma (HCC) Professor Muhammad Umar MBBS, MCPS, FCPS (PAK), FACG (USA), FRCP (L), FRCP (G), ASGE-M(USA), AGAF (USA) Chair & Professor of Medicine Rawalpindi Medical College
More informationLearning Objectives. After attending this presentation, participants will be able to:
Learning Objectives After attending this presentation, participants will be able to: Describe HCV in 2015 Describe how to diagnose advanced liver disease and cirrhosis Identify the clinical presentation
More informationHepatocellular 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 informationHepatocellular Carcinoma: A major global health problem. David L. Wood, MD Interventional Radiology Banner Good Samaritan Medical Center
Hepatocellular Carcinoma: A major global health problem David L. Wood, MD Interventional Radiology Banner Good Samaritan Medical Center Hepatocellular Carcinoma WORLDWIDE The #2 Cancer Killer Overall cancer
More informationWorldwide 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 informationA) PUBLIC HEALTH B) PRESENTATION & DIAGNOSIS
Hepatocellular Carcinoma HCC Updated November 2015 by: Dr. Mohammed Alghamdi (Medical Oncology Fellow, University of Calgary), April 2017 by Dr. Jenny Ko (Medical Oncologist, Abbotsford Centre, BC Cancer
More information9th 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 informationCelsion Symposium New Paradigms in HCC Staging: HKLC vs. BCLC Staging
Celsion Symposium New Paradigms in HCC Staging: HKLC vs. BCLC Staging Ronnie T.P. Poon, MBBS, MS, PhD Chair Professor of Hepatobiliary and Pancreatic Surgery Chief of Hepatobiliary and Pancreatic Surgery
More informationScreening 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 information3/22/2017. 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 informationPaul Martin MD FACG. University of Miami
Paul Martin MD FACG University of Miami 1 Liver cirrhosis of any cause Chronic C o c hepatitis epat t s B Risk increases with Male gender Age Diabetes Smoking ~5% increase in HCV-related HCC between 1991-28
More information21/02/2014. Disclosures. HCC: predicting recurrence. Outline. Liver transplant: Beyond Milan?
Disclosures HCC: predicting recurrence Peter Ghali, MD, FRCPC, MSc (epid) None relevant to this talk other than off-label use of sirolimus Toronto, February 2014 Outline Recurrence after what? Locoregional
More informationViral 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 informationHCC: 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 informationLiver Cancer: Diagnosis and Treatment Options
Liver Cancer: Diagnosis and Treatment Options Fred Poordad, MD Chief, Hepatology University Transplant Center Professor of Medicine UT Health, San Antonio VP, Academic and Clinical Affairs, Texas Liver
More informationPercutaneous Ethanol Injection Therapy in the Treatment of Hepatocarcinoma Results Obtained from a Series of 88 Cases
Percutaneous Ethanol Injection Therapy in the Treatment of Hepatocarcinoma Results Obtained from a Series of 88 Cases Mirela Danila, Ioan Sporea, Roxana Sirli, Alina Popescu Department of Gastroenterology
More informationHepatocellular Carcinoma
Hepatocellular Carcinoma Luis S. Marsano, MD Professor of Medicine Division of Gastroenterology, Hepatology, & Nutrition University of Louisville & Louisville VAMC 2010 Magnitude of the Problem 95% of
More informationSurvival Benefit of Locoregional Treatment for Hepatocellular Carcinoma with Advanced Liver Cirrhosis
2235-1795/16/0053-0175$39.50/0 175 Original Paper Survival Benefit of Locoregional Treatment for Hepatocellular Carcinoma with Advanced Liver Cirrhosis Satoshi Kitai a Masatoshi Kudo a Naoshi Nishida a
More informationWorldwide 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 informationNatural History of Chronic Hepatitis B
Natural History of Chronic Hepatitis B Anna SF Lok, MD Alice Lohrman Andrews Professor in Hepatology Director of Clinical Hepatology Assistant Dean for Clinical Research University of Michigan Ann Arbor,
More informationHepatocellular Carcinoma for NNN Cancer Webinar Series
Hepatocellular Carcinoma for NNN Cancer Webinar Series Brian J McMahon, MD Liver Disease and Hepatitis Program Alaska Native Tribal Health Consortium * None Disclosures Outline of Talk * Epidemiology of
More informationHCC Imaging and Advances in Locoregional Therapy. David S. Kirsch MD Ochsner Clinic Foundation
HCC Imaging and Advances in Locoregional Therapy David S. Kirsch MD Ochsner Clinic Foundation -Nothing to disclose Hepatic Imaging Primary imaging modalities include: US CT MR Angiography Nuclear medicine
More informationUPDATE TO THE MANAGEMENT OF PATIENTS WITH HCC HCA
UPDATE TO THE MANAGEMENT OF PATIENTS WITH HCC HUSSEIN K. MOHAMED MD, FACS. Transplant and Hepato-biliary Surgery Largo Medical Center HCA DISCLOSURE I have no financial relationship(s) relevant to the
More informationCirrhotic patients with solitary hepatocellular carcinoma
ORIGINAL ARTICLES Survival of Cirrhotic Patients With Early Hepatocellular Carcinoma Treated by Percutaneous Ethanol Injection or Liver Transplantation Angelo Andriulli, 1 Ilario de Sio, 2 Luigi Solmi,
More informationdoi: /hepr Response Evaluation Criteria in Cancer of the Liver (RECICL) (2015 Revised version)
bs_bs_banner Hepatology Research 2016; 46: 3 9 doi: 10.1111/hepr.12542 Special Report Response Evaluation Criteria in Cancer of the Liver (RECICL) (2015 Revised version) Masatoshi Kudo, Kazuomi Ueshima,
More informationInterventional Radiology in Liver Cancer. Nakarin Inmutto MD
Interventional Radiology in Liver Cancer Nakarin Inmutto MD Liver cancer Primary liver cancer Hepatocellular carcinoma Cholangiocarcinoma Metastasis Interventional Radiologist Diagnosis Imaging US / CT
More informationInterventional Radiologic Treatment of Hepatocellular Carcinoma
Interventional Radiologic Treatment of Hepatocellular Carcinoma Fatih Boyvat Abstract The current treatment modalities for patients with hepatocellular carcinoma are discussed in this review. Hepatocellular
More informationLong-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 informationTreatment 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 information간암의다양한병기분류법 : 현재사용중인병기분류를중심으로. Kim, Beom Kyung
간암의다양한병기분류법 : 현재사용중인병기분류를중심으로 Kim, Beom Kyung Importance of staging system 환자의예후예측 적절한치료방법적용 ( 수술, 방사선, 항암..) 의료진간의 tumor burden 에대한적절한의사소통 향후연구및 clinical trial 시연구집단의성격에대한객관적기준제시 Requisites for good staging
More informationTREATMENT FOR HCC AND CHOLANGIOCARCINOMA. Shawn Pelletier, MD
TREATMENT FOR HCC AND CHOLANGIOCARCINOMA Shawn Pelletier, MD Treatment for HCC Treatment strategies Curative first line therapy Thermal ablation vs Resection vs Transplant Other first line therapies TACE
More informationUtility of Adding Primovist Magnetic Resonance Imaging to Analysis of Hepatocellular Carcinoma by Liver Dynamic Computed Tomography
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2013;11:187 192 Utility of Adding Primovist Magnetic Resonance Imaging to Analysis of Hepatocellular Carcinoma by Liver Dynamic Computed Tomography YOUNG JOO JIN,*
More informationHepatocellular 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 informationComparison of the Outcomes of Hepatocellular Carcinoma Patients Following Local Ablation Therapy and Hepatectomy
Original Article Original Comparison of the Outcomes of Hepatocellular Carcinoma Patients Following Local Ablation Therapy and Kiyohide Kioka ) *, Takashi Nakai ), Yasuko Kawasaki ), Ayako Ueno 2), Yuhei
More informationDysplastic Nodules. Department of Pathology, Chonbuk National University Medical School. Woo Sung Moon. Introduction
Dysplastic Nodules Department of Pathology, Chonbuk National University Medical School Woo Sung Moon 만성간질환에발생하는간의결절병변에는재생결절, 형성이상결절및간세포암종이있다. 여러인자에의해손상받은간세포는괴사와재생과정을반복하며재생결절, 형성이상결절을형성하는동안유전자의변이와 epigenetic
More informationHow to apply HCC prediction models to practice?
How to apply HCC prediction models to practice? Department of Internal Medicine, Keimyung University School of Medicine Woo Jin Chung HCC prediction models 독특하게간세포암환자들의생존은암의진행상태뿐아니라기저간기능의중증정도에영향을받는특성이있다.
More informationAntiviral 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 informationClinical Staging for Hepatocellular Carcinoma: Eastern Perspectives. Osamu Yokosuka, M.D. Graduate School of Medicine, Chiba University, Chiba, Japan
Clinical Staging for Hepatocellular Carcinoma: Eastern Perspectives Osamu Yokosuka, M.D. Graduate School of Medicine, Chiba University, Chiba, Japan Why is staging system important? Cancer stage can be
More informationORIGINAL ARTICLE. Abstract. Introduction
ORIGINAL ARTICLE Prognosis of Patients with Hepatocellular Carcinoma Treated Solely with Transcatheter Arterial Chemoembolization: Risk Factors for One-year Recurrence and Two-year Mortality (Preliminary
More informationMULTI-DISCIPLINARY MANAGEMENT OF INTERMEDIATE STAGE HCC
Dr Apoorva Gogna MBBS FRCR FAMS Consultant Interventional Radiology Center Department of Diagnostic Radiology SingaporeGeneral Hospital MULTI-DISCIPLINARY MANAGEMENT OF INTERMEDIATE STAGE HCC CASE HISTORY
More informationUPDATE OF EASL CLINICAL PRACTICE GUIDELINES: MANAGEMENT OF HEPATOCELLULAR CARCINOMA*
UPDATE OF EASL CLINICAL PRACTICE GUIDELINES: MANAGEMENT OF HEPATOCELLULAR CARCINOMA* Dr. Catherine Frenette Medical Director of Liver Transplantation, Scripps Green Hospital, La Jolla, CA, USA May 2018
More informationRisk 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 informationThe 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 informationHepatocellular 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 informationSorafenib for Egyptian patients with advanced hepatocellular carcinoma; single center experience
Journal of the Egyptian National Cancer Institute (2014) 26, 9 13 Cairo University Journal of the Egyptian National Cancer Institute www.nci.cu.adu.eg www.sciencedirect.com Original article Sorafenib for
More informationReconsidering Liver Transplantation for HCC in a Era of Organ shortage
Reconsidering Liver Transplantation for HCC in a Era of Organ shortage Professor Didier Samuel Centre Hépatobiliaire Inserm-Paris Sud Research Unit 1193 Departement Hospitalo Universitaire Hepatinov Hôpital
More informationLiver Cancer And Tumours
Liver Cancer And Tumours What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood from all parts of the body, cancer cells from elsewhere can
More informationExtending Indication: Role of Living Donor Liver Transplantation for Hepatocellular Carcinoma
LIVER TRANSPLANTATION 13:S48-S54, 27 SUPPLEMENT Extending Indication: Role of Living Donor Liver Transplantation for Hepatocellular Carcinoma Satoru Todo, 1 Hiroyuki Furukawa, 2 Mitsuhiro Tada, 3 and the
More information3 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 informationRADIATION SEGMENTECTOMY. Robert J Lewandowski, MD
RADIATION SEGMENTECTOMY Robert J Lewandowski, MD Robert Lewandowski, M.D. Consultant/Advisory Board: Cook Medical, LLC, Arsenal, BTG International, Boston Scientific Corp., ABK Reference Unlabeled/Unapproved
More informationWhite 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 informationTrans-arterial radioembolisation (TARE) of unresectable HCC using Y-90 microspheres: is it dangerous in case of portal vein thrombosis?
Trans-arterial radioembolisation (TARE) of unresectable HCC using Y-90 microspheres: is it dangerous in case of portal vein thrombosis? Poster No.: C-1634 Congress: ECR 2014 Type: Authors: Keywords: DOI:
More informationClinical outcomes of patients with a single hepatocellular carcinoma less than 5 cm treated with transarterial chemoembolization
ORIGINAL ARTICLE 2018 Oct 26. [Epub ahead of print] https://doi.org/10.3904/kjim.2018.058 Clinical outcomes of patients with a single hepatocellular carcinoma less than 5 cm treated with transarterial
More informationStatus of hepatocellular carcinoma in Gulf region
Review Article Page 1 of 6 Status of hepatocellular carcinoma in Gulf region Kakil Ibrahim Rasul 1,2, Safaa H. Al-Azawi 1, Prem Chandra 3, Ghassan K. Abou-Alfa 4,5, Alexander Knuth 1 1 National Center
More informationClinical 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 informationAASLD PRACTICE GUIDELINE. Management of Hepatocellular Carcinoma: An Update. Surveillance and Diagnosis. Staging and Treatment of HCC
AASLD PRACTICE GUIDELINE Management of Hepatocellular Carcinoma: An Update Jordi Bruix, 1 and Morris Sherman 2 Since the publication of the American Association for the Study of Liver Diseases (AASLD)
More informationHepatocellular 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 informationHepatocellular carcinoma (HCC) is a significant cause of
Surveillance and Diagnosis of Hepatocellular Carcinoma Paul Fitzmorris, MD, and Ashwani K. Singal, MD, MS Dr Fitzmorris is a resident in the Department of Medicine and Dr Singal is a professor in the Division
More informationDetection and Characterization of Hepatocellular Carcinoma by Imaging
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2005;3:S136 S140 Detection and Characterization of Hepatocellular Carcinoma by Imaging OSAMU MATSUI Department of Imaging Diagnosis and Interventional Radiology,
More informationLiver 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 informationIl treatment plan nella terapia sistemica dell epatocarcinoma
Il treatment plan nella terapia sistemica dell epatocarcinoma M. Iavarone, MD PhD CRC A.M. e A. Migliavacca Center for the Study of Liver Disease Division of Gastroenterology and Hepatology Fondazione
More informationRICCARDO LENCIONI,CLOTILDE DELLA PINA, LAURA CROCETTI,DANIA CIONI. Chapter 1
RICCARDO LENCIONI,CLOTILDE DELLA PINA, LAURA CROCETTI,DANIA CIONI Chapter 1 Impact of European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on the Use of Contrast
More informationHepatocellular 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 informationRadiation burden of hepatocellular carcinoma screening program in hepatitis B virus patients should we recommend magnetic resonance imaging instead?
Radiation burden of hepatocellular carcinoma program in hepatitis B virus patients should we recommend magnetic resonance imaging instead? Background: Current Hepatocellular Carcinoma (HCC) surveillance
More informationViral 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 informationStaging and prognostic systems: beyond BCLC?
Staging and prognostic systems: beyond BCLC? Alessandro Vitale, MD, PhD, FEBS U.O.C. di Chirurgia Epatobiliare e dei Trapianti Epatici, Department of Surgery, Oncology and Gastroenterology, University
More informationSelection of patients of hepatocellular carcinoma beyond the Milan criteria for liver transplantation
Title Selection of patients of hepatocellular carcinoma beyond the Milan criteria for liver transplantation Author(s) Chan, SC; Fan, ST Citation Hepatobiliary Surgery and Nutrition, 2013, v. 2 n. 2, p.
More informationRESEARCH ARTICLE. Real Life Treatment of Hepatocellular Carcinoma: Impact of Deviation from Guidelines for Recommended Therapy
DOI:http://dx.doi.org/10.7314/APJCP.2015.16.16.6929 Real-Life HCC Treatment - Influence on Outcome of Deviation from Therapy Guidelines RESEARCH ARTICLE Real Life Treatment of Hepatocellular Carcinoma:
More informationTransient 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 informationNegative impact of low body mass index on liver cirrhosis patients with hepatocellular carcinoma
Li et al. World Journal of Surgical Oncology (2015) 13:294 DOI 10.1186/s12957-015-0713-4 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH Open Access Negative impact of low body mass index on liver cirrhosis
More informationMultimodal therapy for hepatocellular carcinoma: A complementary approach to liver transplantation
ORIGINAL ARTICLE Multimodal therapy for hepatocellular carcinoma: a complementary approach to liver transplantation., 2010; 9 (1): 23-32 January-March, Vol. 9 No.1, 2010: 23-32 23 ABSTRACT Multimodal therapy
More informationForum. Non-surgical treatment of primary liver cancer. Abstract. Staging systems
Non-surgical treatment of primary liver cancer Simone I Strasser AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia Email: strassers@email.cs.nsw.gov.au
More informationHepatocellular carcinoma: Options for diagnosing and managing a deadly disease
REVIEW CME CREDIT EDUCATIONAL OBJECTIVE: Readers will recognize the risk of hepatocellular carcinoma in patients with cirrhosis, regardless of the cause of the cirrhosis ARVIND R. MURALI, MD Department
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 ) 1 Sorafenib Improves Survival in Hepatocellular Carcinoma: Results of a Phase III Randomized, -Controlled Trial Josep M. Llovet, Sergio Ricci, Vincenzo Mazzaferro, Philip
More informationSEQUENCING OF HCC TREATMENT. Dr. Amit G. Singal Medical Director, UT Southwestern Medical Center, USA
SEQUENCING OF HCC TREATMENT Dr. Amit G. Singal Medical Director, UT Southwestern Medical Center, USA February 2018 DISCLAIMER Please note: The views expressed within this presentation are the personal
More informationAccepted Manuscript. Unexpected high incidence of hepatocellular carcinoma in patients with hepatitis C in the era of DAAs: too alarming?
Accepted Manuscript Unexpected high incidence of hepatocellular carcinoma in patients with hepatitis C in the era of DAAs: too alarming? Qing-Lei Zeng, Zhi-Qin Li, Hong-Xia Liang, Guang-Hua Xu, Chun-Xia
More informationHistologic Characteristics of Hepatocellular Carcinomas Showing Atypical Enhancement Patterns on 4-Phase MDCT Examination
Original Article http://dx.doi.org/10.3348/kjr.2012.13.5.586 pissn 1229-6929 eissn 2005-8330 Korean J Radiol 2012;13(5):586-593 Histologic Characteristics of Hepatocellular Carcinomas Showing Atypical
More informationCombination of TACE and Sorafenib Improves Outcomes in BCLC Stages B/C of Hepatocellular Carcinoma: A Single Centre Experience
TACE + sorefanib for advanced HCC., 2017; 16 (2): 247-254 ORIGINAL ARTICLE March-April, Vol. 16 No. 2, 2017: 247-254 247 The Official Journal of the Mexican Association of Hepatology, the Latin-American
More informationUpdate EASL Clinical Practice Guidelines: Management of Hepatocellular Carcinoma
Update EASL Clinical Practice Guidelines: Management of Hepatocellular Carcinoma Peter R. Galle PHC 2018 - www.aphc.info Disclosure of Conflict of Interest Peter R. Galle I have the following financial
More informationHepatocellular carcinoma: from guidelines to individualized treatment
AISF 2012 Rome, 22-24 February 2012 Hepatocellular carcinoma: from guidelines to individualized treatment A.D. 1088 Luigi Bolondi Professor of Medicine, Chairman Department of Digestive Diseases and Internal
More informationHepatobiliary Malignancies Retrospective Study at Truman Medical Center
Hepatobiliary Malignancies 206-207 Retrospective Study at Truman Medical Center Brandon Weckbaugh MD, Prarthana Patel & Sheshadri Madhusudhana MD Introduction: Hepatobiliary malignancies are cancers which
More informationStudy Objective and Design
Randomized, Open Label, Multicenter, Phase II Trial of Transcatheter Arterial Chemoembolization (TACE) Therapy in Combination with Sorafenib as Compared With TACE Alone in Patients with Hepatocellular
More informationTherapeutic Response Assessment and Endpoints in HCC
APASL HCC Conference, 2013 Cebu Therapeutic Response Assessment and Endpoints in HCC Ronnie T.P. Poon, MBBS, MS, PhD Chair Professor of Surgery Chief of Hepatobiliary and Pancreatic Surgery The University
More information