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      From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world

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          Abstract

          Hepatocellular carcinoma (HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer Staging System remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma.

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          Most cited references65

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          Management of hepatocellular carcinoma.

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            Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver.

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              Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma.

              The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.
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                Author and article information

                Journal
                World J Gastroenterol
                World J. Gastroenterol
                WJG
                World Journal of Gastroenterology
                Baishideng Publishing Group Inc
                1007-9327
                2219-2840
                7 August 2017
                7 August 2017
                : 23
                : 29
                : 5282-5294
                Affiliations
                Dimitrios Dimitroulis, Christos Damaskos, Nikolaos Garmpis, Stylianos Kykalos, Gerasimos Tsourouflis, Konstantinos Kontzoglou, Gregory Kouraklis, Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
                Serena Valsami, Blood Transfusion Department, Aretaieion Hospital, Medical School, National and Kapodistrian Athens University, 15772 Athens, Greece
                Spyridon Davakis, First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
                Eleftherios Spartalis, N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
                Antonios Athanasiou, Department of Surgery, Mercy University Hospital, Grenville Pl, T12 WE28 Cork, Ireland
                Demetrios Moris, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
                Stratigoula Sakellariou, Ioanna Delladetsima, First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
                Anna Garmpi, Internal Medicine Department, Laiko General Hospital, University of Athens Medical School, 15772 Athens, Greece
                Author notes

                Author contributions: Dimitroulis D and Damaskos C contributed equally to this work; Dimitroulis D, Damaskos C, Valsami S and Davakis S designed the research and wrote the paper; Dimitroulis D, Damaskos C, Garmpis N, Kykalos S, Delladetsima I, Kontzoglou K and Kouraklis G reviewed the paper; Spartalis E, Athanasiou A, Moris D, Sakellariou S, Tsourouflis G and Garmpi A collected the data.

                Correspondence to: Dimitrios Dimitroulis, MD, MSc, PhD, Assistant Professor of Surgery, Second Department of Propedeutic Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Medical School, 17 Agiou Thoma Street, 11527 Athens, Greece. dimitroulisdimitrios@ 123456yahoo.com

                Telephone: +30-697-2420547 Fax: +30-213-2061772

                Article
                jWJG.v23.i29.pg5282
                10.3748/wjg.v23.i29.5282
                5550777
                28839428
                99c9fde9-fcf9-44e0-8480-ae32b8953da2
                ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                : 15 March 2017
                : 3 May 2017
                : 9 June 2017
                Categories
                Review

                hepatocellular,cancer,epidemiology,treatment,diagnosis,staging,transplantation

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