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Vol 5, No 4 (2009)
Review paper
Published online: 2009-07-30
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Hepatocellular carcinoma - diagnosis and treatment

Maciej Krzakowski, Krzysztof Zieniewicz, Andrzej Habior, Andrzej Horban, Włodzimierz Olszewski, Janusz Cianciara, Krzysztof Simon, Marek Hartleb, Jarosław Reguła, Ryszard Pacho, Olgierd Rowiński, Bogna Ziarkiewicz-Wróblewska, Marek Krawczyk, Piotr Małkowski, Jacek Jassem
Onkol. Prak. Klin 2009;5(4):125-140.

open access

Vol 5, No 4 (2009)
REVIEW ARTICLES
Published online: 2009-07-30

Abstract

Hepatocellular carcinoma usually is a consequence of underlying viral hepatitis. Both, the incidence and mortality rates have increased in recent decades. The majority of patients are still diagnosed with advanced disease. The identifiable population at risk of development malignancy makes early detection a realistic possibility and every 6 months liver imaging is currently recommended for patients with cirrhosis. The diagnosis should be based on clinical findings together with radiologic imaging and microscopic examination. Resection is preferred treatment for patients with the disease confined to one region of the liver and preserved hepatic function with no evidence of portal hypertension. Liver transplantation is the best option for small lesions found in cirrhosis. Chemoembolization and thermoablation are effective methods of treatment of small - up to 3 cm in diameter - lesions in patients who otherwise are not candidates for resection or as a bridge to liver transplantation. Systemic chemotherapy is of marginal value, whereas the use of sorafenib - a small-molecule angiogenesis inhibitor - may prolong survival in well-selected patients.

Abstract

Hepatocellular carcinoma usually is a consequence of underlying viral hepatitis. Both, the incidence and mortality rates have increased in recent decades. The majority of patients are still diagnosed with advanced disease. The identifiable population at risk of development malignancy makes early detection a realistic possibility and every 6 months liver imaging is currently recommended for patients with cirrhosis. The diagnosis should be based on clinical findings together with radiologic imaging and microscopic examination. Resection is preferred treatment for patients with the disease confined to one region of the liver and preserved hepatic function with no evidence of portal hypertension. Liver transplantation is the best option for small lesions found in cirrhosis. Chemoembolization and thermoablation are effective methods of treatment of small - up to 3 cm in diameter - lesions in patients who otherwise are not candidates for resection or as a bridge to liver transplantation. Systemic chemotherapy is of marginal value, whereas the use of sorafenib - a small-molecule angiogenesis inhibitor - may prolong survival in well-selected patients.
Get Citation

Keywords

hepatocellular carcinoma; liver resection; liver transplatation; systemic therapy

About this article
Title

Hepatocellular carcinoma - diagnosis and treatment

Journal

Oncology in Clinical Practice

Issue

Vol 5, No 4 (2009)

Article type

Review paper

Pages

125-140

Published online

2009-07-30

Bibliographic record

Onkol. Prak. Klin 2009;5(4):125-140.

Keywords

hepatocellular carcinoma
liver resection
liver transplatation
systemic therapy

Authors

Maciej Krzakowski
Krzysztof Zieniewicz
Andrzej Habior
Andrzej Horban
Włodzimierz Olszewski
Janusz Cianciara
Krzysztof Simon
Marek Hartleb
Jarosław Reguła
Ryszard Pacho
Olgierd Rowiński
Bogna Ziarkiewicz-Wróblewska
Marek Krawczyk
Piotr Małkowski
Jacek Jassem

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