Hepatocellular carcinoma: current trends in worldwide epidemiology, risk factors, diagnosis, and therapeutics

Abstract

Hepatocellular carcinoma (HCC) is a common malignancy in developing countries and its incidence is on the rise in the developing world. The epidemiology of this cancer is unique since its risk factors, including hepatitis C and B, have been clearly established. The current trends in the shifting incidence of HCC in different regions of the world can be explained partly by the changing prevalence of hepatitis. Early detection offers the only hope for curative treatment for patients with HCC, hence effective screening strategies for high-risk patients is of utmost importance. Liver transplantation and surgical resection remains the cornerstone of curative treatment. But major advances in locoregional therapies and molecular-targeted therapies for the treatment of advanced HCC have occurred recently. In this review, current trends in the worldwide epidemiology, surveillance, diagnosis, standard treatments, and the emerging therapies for HCC are discussed.

Cyclic adenosine monophosphate-responsive element-binding protein activation predicts an unfavorable prognosis in patients with hepatocellular carcinoma

“…As a highly aggressive solid tumor, HCC is characterized by fast infiltrating growth, early metastasis, high-grade malignancy, and poor prognosis 4. Despite improvements in diagnostic and therapeutic approaches, the 5-year survival rate of this cancer is merely 7%, because of a high incidence of postoperative metastasis and recurrence, and the high resistance of HCC to chemotherapy 5. This disappointing outcome clearly suggests that the current knowledge regarding diagnosis, prevention, and treatment of this cancer is insufficient.…”

Liver Transplantation for Intermediate-Stage Hepatocellular Carcinoma

“…In the last two decades, multidisciplinary treatments for HCC have improved, including hepatic resection (HR), radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and liver transplantation (LT). Selection of a particular therapy depends on the tumor features, degree of underlying liver function, and availability of the treatment modality and local clinical expertise [3-5]. …”

Roles of p53 in extrinsic factor-induced liver carcinogenesis

“…[1,2] The majority of these cases (about 80%) occur in Eastern Asia, South-Eastern Asia, Mid-Africa, and West Africa, within the context of viral hepatitis. [2-4] Although there are genetic etiologies for hepatocellular carcinoma (HCC) including hereditary hemochromatosis and α1-antitrypsin deficiency, [5-7] viral hepatitis, as well as exposure to other extrinsic factors, such as aflatoxin B1 (AFB1), polyvinyl chloride (PVC), a poor diet inducing non-alcoholic fatty liver disease (NAFLD), and excess iron exposure, remain among the most common causes of liver cancer. [8,9] Despite vaccinations for hepatitis B virus (HBV), new treatments for hepatitis C virus (HCV), regulations governing PVC production, and restrictions preventing AFB1 contamination of food products, countries still struggle to prevent liver cancer.…”