Algorithms of diagnosis and options of hepatocellular carcinoma therapy

摘要

In the past two decades hepatocellular carcinoma (HCC) has experienced a progressive increase in its incidence, at present constituting the sixth most common cancer worldwide, the third cause of cancer-related mortality1 and the main cause of death among cirrhotic patients. These facts are mostly due to the long-term impact of chronic hepatitis C virus (HCV) infection, along with the increase in early detection.In developed areas cirrhosis underlies HCC in the majority of cases, and this preneoplastic entity is considered the main risk factor for HCC. The available potential curative treatments (surgical resection, liver transplantation and percutaneous ablation) are applicable in only a relatively small proportion of asymptomatic early-stage cases. For this reason surveillance for HCC in cirrhotic patients is recommended, and relies on biannual abdominal ultrasound in patients who would benefit from effective treatment if HCC were diagnosed.