Strategies for the management of hepatocellular carcinoma

Abstract

Hepatocellular carcinoma (HCC) generally develops as a consequence of underlying liver disease, most commonly viral hepatitis. The development of HCC follows an orderly progression from cirrhosis to dysplastic nodules to early cancer development, which can be reliably cured if discovered before the development of vascular invasion (typically occurring at a tumor diameter of approximately 2 cm). The identifiable population at risk makes screening a realistic possibility, and liver imaging is recommended every 6 months for patients with cirrhosis. For patients with preserved liver function and no portal hypertension who develop HCC that is confined to one region of the liver, resection is the preferred treatment. If resection is not possible because of poor liver function, and the HCC is within the Milan criteria (1 nodule > or =5 cm, 2-3 nodules > or =3 cm), liver transplantation is the treatment of choice. To prevent tumor progression while waiting, nonsurgical treatments including percutaneous ethanol injection, radiofrequency ablation, and transarterial chemoembolization are employed, but drop-out from the waiting list remains a problem. Living donor transplantation is an alternative that can eliminate drop-out and enable liver transplantation for patients with HCC whose disease does not fall within the Milan criteria. There is a need for more effective adjuvant therapies after resection and liver transplantation; newer antiangiogenic agents offer hope for improved outcomes in the future.

Accelerated carcinogenesis following liver regeneration is associated with chronic inflammation-induced double-strand DNA breaks

“…However, survival rates following PHx are suboptimal, mostly because of tumor recurrence, which, within 5 years, is in the range of 75-100% of cases (10,11). Undetected intrahepatic lesions attribute to 60-70% of recurrences, whereas 30-40% are de novo HCCs (12).…”

Immunobiology of Monocytes/Macrophages in Hepatocellular Carcinoma

“…Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and characterized by progressive development, high postsurgical recurrence and extremely poor prognosis [1][2][3]. The dismal outcome has been attributed to the highly vascular nature of HCC, which increases the propensity to spread and invade into neighboring or distant sites [4,5].…”

Synthesis of 3-aroyl-4-aryl-1-isopropylamino-4-piperidinols and evaluation of the cytotoxicities of the compounds against human hepatoma and breast cancer cell lines

“…Similarly, hepatocellular carcinoma (HCC) is the fifth most common and the third most deadly cancer disease worldwide 2 . For most patients with HCC, surgery is the only curative treatment procedure because HCC cells have high resistance to the chemotherapeutic agents 3 . In the light of these information mentioned above, novel approaches and cytotoxic agents are urgently needed in the treatment of breast cancer and HCC.…”