Mini Review - Journal of Systems Biology & Proteome Research (2022) Volume 3, Issue 1
Management patients at risk for hepatocellular carcinoma
Mario Niklas*
Barcelona Clinic Liver Cancer Group, Hospital Clinic, University of Barcelona, Spain
- *Corresponding Author:
- Mario Niklas
Barcelona Clinic Liver Cancer Group
Hospital Clinic, University of Barcelona
Spain
E-mail: marioniklas@edu.sp
Received: 31-Dec-2021, Manuscript No. AASBPR-22-54620; Editor assigned: 03-Jan-2022, PreQC No. AASBPR-22-54620(PQ); Reviewed: 17-Jan-2022, QC No.
AASBPR-22-54620; Revised: 21-Jan-2022, Manuscript No. AASBPR-22-54620(R); Published: 28-Jan-2022, DOI:10.35841/aasbpr-3.1.102
Citation: Niklas M. Management patients at risk for hepatocellular carcinoma. J Syst Bio Proteome Res. 2022;3(1):3-4.
Abstract
The most frequent type of primary liver cancer is hepatocellular carcinoma (HCC). Despite attempts at prevention and screening, as well as the development of novel diagnostic and treatment technologies, the prevalence of HCC has doubled in recent decades, and fatality rates have risen. HCC is linked to a number of crucial risk factors, with any type of cirrhosis, regardless of cause, being the most significant contributor. Hepatitis C virus infection with cirrhosis or bridging fibrosis is a separate risk factor from hepatitis B virus infection. In the majority of cases, HCC is diagnosed without a liver biopsy. Ultrasound and alpha-fetoprotein (AFP) screening at intervals is recommended, however it is insufficient for patients on the orthotopic liver transplantation (OLT) waiting list. Due to their greater sensitivity and specificity, triple-phase computed tomography and/or magnetic resonance imaging are utilised in conjunction with the detection of AFP, AFP-L3 percent, and/or des-gamma-carboxy prothrombin. There are several therapy options, but only surgical resection and OLT are curative. Only patients who meet or are downstaged into Milan or University of California, San Francisco criteria are eligible for OLT. Radiofrequency ablation, microwave ablation, percutaneous ethanol injection, transarterial chemoembolization, radioembolization, cryoablation, radiation therapy, stereotactic radiotherapy, systemic chemotherapy, and molecularly targeted medicines are some of the additional treatment options. The size and location of the tumour, extrahepatic metastasis, and underlying liver function all play a role in HCC treatment. Because of the disease's intricacy, patients are frequently best managed in centres with experience with HCC, where a multidisciplinary approach can be used
Keywords
Hepatocellular carcinoma, Hepatoma, Sorafenib, Liver transplantation, Radiofrequency ablation, Transarterial chemoembolization
Introduction
The most frequent type of primary liver cancer is hepatocellular carcinoma (HCC). It is the third most common cause of cancer death worldwide, and the ninth most common cause of cancer death in the United States. New instances of liver and intrahepatic bile duct cancer, as well as deaths, were anticipated to occur in 2013 [1]. Overall, men are more likely than women to get liver cancer, with a ratio of Eastern and Southeastern Asia, Middle and Western Africa, Melanesia, and Micronesia/Polynesia having higher rates than developed regions. However, patterns of incidence and death are shifting [2]. In the United States, the incidence of HCC has doubled in recent decades, and HCC fatality rates have risen. HCC has an estimated year survival rate of less than, making it one of the nation's fastest-growing causes of mortality. The prevalence of HCC was found to be highest among Asians, approximately double that of white Hispanics, and times greater than that of non-Hispanic whites, according to a population-based study in the United States. Preventing hepatitis B and C virus infection, treating patients with viral hepatitis who are candidates for treatment, avoiding environmental toxins, encouraging heavy alcohol abstinence, and removing excess iron from patients with hereditary hemochromatosis should all be priorities in the fight against HCC [3].
Several studies have looked at how treatment for persistent HBV and HCV infections affects the risk of HCC; one study found that antiviral medication lowered the cumulative incidence of HCC by in HCV patients and by in HBV patients. The effect is particularly important in HCV-infected individuals who achieve a durable virologic response; nonetheless, those patients still require screening and surveillance. There has also been evidence of a link between alcohol consumption and HCV/ HBV infection [4]. People who drink a lot of alcohol have an elevated risk of liver cancer by about a factor of two. Other than the symptoms of chronic liver disease, patients normally have none. HCC should be suspected in patients with previously compensated cirrhosis who experience decompensation, as this is frequently accompanied with tumour extension into the hepatic or portal vein, as well as arteriovenous shunting caused by the tumour. In many cases, extrahepatic spread is present at the time of diagnosis. The lung, intra-abdominal lymph nodes, bone, and adrenal glands are the most common sites, in that order [5].
Conclusion
In the United States, HCC is a fast increasing source of morbidity and mortality. Despite the fact that HCC is a deadly disease, the best chance for a long life is to screen and diagnose it early. Although different hepatology associations have different preferred methods of surveillance, most patients can get by with US with or without AFP every six months. There are a variety of therapeutic methods available, and additional approaches are being researched. Patients are frequently best served in centres with experience in HCC management, where a multidisciplinary approach can be used, due to the disease's complexity. Advances in HCC prevention, early identification, and therapy have improved survival and prognosis for a disease that was formerly thought to be fatal only a few decades ago.
References
- McGlynn KA, Tsao L, Hsing AW, et al. International trends and patterns of primary liver cancer. Int J Cancer. 2001;94(2):290-296.
- Wong R, Corley DA. Racial and ethnic variations in hepatocellular carcinoma incidence within the United States. Am J Med. 2008;121(6):525-531.
- Davila JA, Morgan RO, Shaib Y, et al. Hepatitis C infection and the increasing incidence of hepatocellular carcinoma: a population-based study. Gastroenterology. 2004;127(5):1372-1380.
- Shen YC, Hsu C, Cheng CC, et al. A critical evaluation of the preventive effect of antiviral therapy on the development of hepatocellular carcinoma in patients with chronic hepatitis C or B: a novel approach by using meta-regression. Oncology. 2012;82(5):275-289.
- Hassan MM, Hwang LY, Hatten CJ, et al. Risk factors for hepatocellular carcinoma: synergism of alcohol with viral hepatitis and diabetes mellitus. Hepatology. 2002;36(5):1206-1213.
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