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2015 ; 17
(12
): 988-95
Nephropedia Template TP
Sastre J
; Díaz-Beveridge R
; García-Foncillas J
; Guardeño R
; López C
; Pazo R
; Rodriguez-Salas N
; Salgado M
; Salud A
; Feliu J
Clin Transl Oncol
2015[Dec]; 17
(12
): 988-95
PMID26607931
show ga
Hepatocellular carcinoma (HCC) represents the second leading cause of
cancer-related death worldwide. Surveillance with abdominal ultrasound every
6 months should be offered to patients with a high risk of developing HCC:
Child-Pugh A-B cirrhotic patients, all cirrhotic patients on the waiting list for
liver transplantation, high-risk HBV chronic hepatitis patients (higher viral
load, viral genotype or Asian or African ancestry) and patients with chronic
hepatitis C and bridging fibrosis. Accurate diagnosis, staging and functional
hepatic reserve are crucial for the optimal therapeutic approach. Characteristic
findings on dynamic CT/MR of arterial hyperenhancement with "washout" in the
portal venous or delayed phase are highly specific and sensitive for a diagnosis
of HCC in patients with previous cirrhosis, but a confirmed histopathologic
diagnosis should be done in patients without previous evidence of chronic hepatic
disease. BCLC classification is the most common staging system used in Western
countries. Surgical procedures, local therapies and systemic treatments should be
discussed and planned for each patient by a multidisciplinary team according to
the stage, performance status, liver function and comorbidities. Surgical
interventions remain as the only curative procedures but both local and systemic
approaches may increase survival and should be offered to patients without
contraindications.
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