%0 Journal Article
%T Hepatocellular Carcinoma: Focus on Different Aspects of Management
%A Sene Waly Raphael
%A Zhang Yangde
%A Chen YuXiang
%J ISRN Oncology
%D 2012
%R 10.5402/2012/421673
%X Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third cause of cancer-related mortality worldwide. Its incidence is clearly arising comprised by the prevalence of major risk factors mainly hepatitis B and hepatitis C. The population at risk is composed of chronic liver patients at the stage of extensive fibrosis or cirrhosis. The monitoring programs of this population have allowed early detection of disease management to promote a radical therapy. Understanding the carcinogenic process and the mastery of the staging systems remain essential keys in diagnosis and treatment of HCC. Recent advances in diagnosis and new treatments have made important impacts on the disease by increasing survival rates and improving quality of life for HCC patients. This paper outlines the different management aspects of HCC which include epidemiology, prevention, carcinogenesis, staging systems, diagnosis, surveillance, and the treatment. 1. HCC Epidemiology HCC is the most common primary liver cancer. The annual number of new cases of HCC worldwide is over one million, making it the 5th most common cancer worldwide and the 3rd leading cause of cancer-related death, preceded only by the lung and stomach cancers [1¨C6]. The global distribution varies by region due to factors at the origin of the disease. HCC is an end result of some chronic infections with the hepatitis B (HBV) or the hepatitis C (HCV) Figure 1 [7¨C9]. More than 80% of HCCs develop in Asian and African countries where between 40% and 90% of HCCs are attributable to chronic hepatitis B [1, 10]. China especially comprises more than half the rate of new cases recorded with over 55% (around 120 million people in China are carriers of the HBV corresponding to almost a third of people infected worldwide [11, 12]. In Singapore, Japan, and Australia/New Zealand, HCC infection is exceptionally due to the high incidence of HVC infections [13¨C15]. Prevalence of HCV infections is reported to be the main leading cause of HCC in Europe and also in the United States where the incidence is relatively low. Currently, there are an estimated 3 million people in United States with chronic hepatitis C; these patients are estimated to develop HCC at a rate of 0.5% to 5% per year [12]. In Europe, the incidence of HCV may be related to the extensive campaign to vaccinate children in the years 1940s to 1950s and possibility to inadequate sterilization of nondisposable needles and syringes up to the mid-1970s. Those infected with hepatitis C during this period have now been infected for 30 years and therefore
%U http://www.hindawi.com/journals/isrn.oncology/2012/421673/