Current Guidelines for the Diagnosis and Management of Hepatocellular Carcinoma: A Comparative Review

Arslanoğlu, Atilla; Seyal, Adeel R.; Sodagari, Faezeh; Sahin, Azize; Miller, Frank H.; Salem, Riad; Yaghmai, Vahid

doi:10.2214/ajr.15.15490

Cited by 37 publications

(33 citation statements)

References 34 publications

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“…Diagnosis is based, according to global recommendations, on the combination of medical imaging and histology [2,15,16] . The radiological aspects are very suggestive of the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma associated to Behçet's disease

Bouomrani¹,

Rim²,

DhiaEddine³

et al. 2019

Curr Cancer Rep

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The occurrence of hepatocellular carcinoma (HCC) on a healthy liver is exceptional and represents a real diagnosis challenge for the clinician. Recently a particularly increased risk of cancer during Behçet's disease (BD) was reported by several studies. Only a few sporadic cases of liver cancer associated with this vascultis have been reported. We report an original observation of non-fibrolamellar HCC occurring on healthy liver in a Tunisian patient followed for BD. A 43-year-old man, followed since the age of 25 for BD with isolated cutaneous and mucosal involvement, and treated by colchicine, was admitted for exploration of a pain of the right hypochondrium evolving since a few months associated with an important slimming, anorexia, and evening fever. The clinical examination noted a firm and painful hepatomegaly. Radiological exploration (ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI)) showed a bulky hepatic tumor with highly developed arterial blood supply. Ultrasound-guided biopsy concluded at HCC without signs of fibrolamellar type or cirrhosis. Biological tests were without abnormalities and specific investigations eliminated underlying chronic hepatopathy (chronic viral hepatitis B or C, hemochromatosis, Wilson's disease or autoimmune hepatitis). The patient was treated symptomatically given the advanced stage of cancer. He quickly died after a month because of a multi-organ failure. HCC on healthy liver is exceptional and BD was suggested as a possible contributing factor. Thus, regular radiological monitoring seems to be recommended in any patient followed for BD, especially those with hepatic veins thrombosis.

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“…Diagnosis is based, according to global recommendations, on the combination of medical imaging and histology [2,15,16] . The radiological aspects are very suggestive of the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma associated to Behçet's disease

Bouomrani¹,

Rim²,

DhiaEddine³

et al. 2019

Curr Cancer Rep

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“…The American College of Radiology has developed the Liver Imaging Reporting Data System, a system for standardization of performance, interpretation, and data collection of CT or MRI. This system stratifies the lesions into five categories, from benign to definitely HCC . In nodules larger than 1 cm, a diagnosis of HCC can be made in liver cirrhosis if the nodule has an arterial contrast uptake followed by contrast “washout” in the delayed venous phase observed on either MRI or CT .…”

Section: Misconception 2: Liver Biopsy Is Necessary To Diagnose Hccmentioning

confidence: 99%

Misconceptions Surrounding Hepatocellular Carcinoma

Orekondy

Eswaran

2018

Clinical Liver Disease

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“…Thus, alternative response criteria, such as modified RECIST (mRECIST), the European Association for the Study of the Liver (EASL), and the Choi criteria, take into account changes in lesion vascularity or viability, which is measured by contrast‐enhanced computed tomography (CT) . The mRECIST for HCC was adopted by the international guidelines on the management of HCC, but the use of RECIST1.1 and mRECIST is only suggested for the assessment of response of HCC treated with systemic therapy such as sorafenib because there is no clear evidence of its accuracy . This might be because these criteria are still dependent on manual radiological assessments based on the simple measurement of the longest diameter (LD) of the lesion .…”

Section: Introductionmentioning

confidence: 99%

Assessment of tumor volume and density as a measure of the response of advanced hepatocellular carcinoma to sorafenib: Application of automated measurements on computed tomography scans

et al. 2019

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Background and Aim To better predict patient survival, we used automated tumor volume and density measurements to make an objective radiological assessment of the response of advanced hepatocellular carcinoma (HCC) to treatment with sorafenib. Methods Patients treated with sorafenib were identified retrospectively. Those who were diagnosed with Child‐Pugh class A liver function, Barcelona‐Clinic Liver Cancer stage C, and Eastern Cooperative Oncology Group performance status grade 0/1 were enrolled (n = 22). Reviews of contrast‐enhanced computed tomography images were supported by the automated measurement of lesions using computer software. Treatment responses were assessed using volume and density criteria. Kaplan–Meier methods and multivariate Cox regression analysis were used to evaluate treatment responses and identify the most significant prognostic factors for overall survival (OS). Results After patients were dichotomized according to volume and density criteria, the median OS for those with an objective response (OR) (complete response + partial response) was 20.4 months and that for those with a non‐OR (stable disease + progressive disease) was 9.3 months (P = 0.009). The best multivariate regression model for survival identified volume and density criteria (OR or non‐OR) as a significant variable, along with baseline alpha‐fetoprotein levels (log‐rank test, P = 0.01). No other conventional criteria were identified as significant. Conclusions Tumor volume and density assessment using automated lesion measurements may be an objective method of evaluating responses of advanced HCC to treatment with sorafenib.

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Current Guidelines for the Diagnosis and Management of Hepatocellular Carcinoma: A Comparative Review

Cited by 37 publications

References 34 publications

Hepatocellular carcinoma associated to Behçet's disease

Hepatocellular carcinoma associated to Behçet's disease

Misconceptions Surrounding Hepatocellular Carcinoma

Assessment of tumor volume and density as a measure of the response of advanced hepatocellular carcinoma to sorafenib: Application of automated measurements on computed tomography scans

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