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      Epidemiology and Management of Hepatocellular Carcinoma

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      Gastroenterology
      Elsevier BV

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          Abstract

          The major risk factors for hepatocellular carcinoma (HCC) in contemporary clinical practice are becoming increasingly related to sustained virological response after hepatitis C, suppressed hepatitis B virus during treatment, and alcoholic and nonalcoholic fatty liver disease. We review the emerging data on the risk and determinants of HCC in these conditions and the implications of HCC surveillance. However, from a public health perspective, active hepatitis C and B continue to drive most of the global burden of HCC. In United States, the age-adjusted incidence rates of HCC in Hispanics have surpassed those of HCC in Asians. Prognosis in HCC is complex because of the competing risk imposed by underlying cirrhosis and presence of malignancy. In addition to tumor burden, liver function and performance status; additional parameters including tumor biopsy, serum markers, and subclassification of current staging systems; and taking into account patterns of tumor progression may improve patient selection for therapy. Advancements in the treatment of HCC have included identification of patients who are most likely to derive a clinically significant benefit from the available therapeutic options. Additionally, the combination strategies of locoregional therapies and/or systemic therapy are being investigated.

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          Author and article information

          Journal
          Gastroenterology
          Gastroenterology
          Elsevier BV
          00165085
          October 2018
          October 2018
          Article
          10.1053/j.gastro.2018.08.065
          6340716
          30367835
          9a068da0-47ae-4512-86d7-1fc016bb5be0
          © 2018

          https://www.elsevier.com/tdm/userlicense/1.0/

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