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      Prognostic Scores and Survival Rates by Etiology of Hepatocellular Carcinoma: A Review

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          Abstract

          Hepatocellular carcinoma (HCC) is a common cancer and ranks sixth among all malignancies worldwide. Risk factors for HCC can be classified as infectious or behavioral. Viral hepatitis and alcohol abuse are currently the most common risk factors for HCC; however, nonalcoholic liver disease is expected to become the most common cause of HCC in upcoming years. HCC survival rates vary according to the causative risk factors. As in any malignancy, staging is crucial in making therapeutic decisions. The selection of a specific score should be individualized according to patient characteristics. In this review, we summarize the current data on epidemiology, risk factors, prognostic scores, and survival in HCC.

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          Hyuna Sung, Jacques Ferlay, Rebecca Siegel … (2021)
          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Hepatocellular carcinoma

            Alejandro Forner, María E Reig, Jordi Bruix (2018)
            Hepatocellular carcinoma appears frequently in patients with cirrhosis. Surveillance by biannual ultrasound is recommended for such patients because it allows diagnosis at an early stage, when effective therapies are feasible. The best candidates for resection are patients with a solitary tumour and preserved liver function. Liver transplantation benefits patients who are not good candidates for surgical resection, and the best candidates are those within Milan criteria (solitary tumour ≤5 cm or up to three nodules ≤3 cm). Image-guided ablation is the most frequently used therapeutic strategy, but its efficacy is limited by the size of the tumour and its localisation. Chemoembolisation has survival benefit in asymptomatic patients with multifocal disease without vascular invasion or extrahepatic spread. Finally, sorafenib, lenvatinib, which is non-inferior to sorafenib, and regorafenib increase survival and are the standard treatments in advanced hepatocellular carcinoma. This Seminar summarises the scientific evidence that supports the current recommendations for clinical practice, and discusses the areas in which more research is needed.
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              Hepatocellular carcinoma

              Josep Llovet, Robin Kate Kelley, Augusto Villanueva … (2021)
              Liver cancer remains a global health challenge, with an estimated incidence of >1 million cases by 2025. Hepatocellular carcinoma (HCC) is the most common form of liver cancer and accounts for ~90% of cases. Infection by hepatitis B virus and hepatitis C virus are the main risk factors for HCC development, although non-alcoholic steatohepatitis associated with metabolic syndrome or diabetes mellitus is becoming a more frequent risk factor in the West. Moreover, non-alcoholic steatohepatitis-associated HCC has a unique molecular pathogenesis. Approximately 25% of all HCCs present with potentially actionable mutations, which are yet to be translated into the clinical practice. Diagnosis based upon non-invasive criteria is currently challenged by the need for molecular information that requires tissue or liquid biopsies. The current major advancements have impacted the management of patients with advanced HCC. Six systemic therapies have been approved based on phase III trials (atezolizumab plus bevacizumab, sorafenib, lenvatinib, regorafenib, cabozantinib and ramucirumab) and three additional therapies have obtained accelerated FDA approval owing to evidence of efficacy. New trials are exploring combination therapies, including checkpoint inhibitors and tyrosine kinase inhibitors or anti-VEGF therapies, or even combinations of two immunotherapy regimens. The outcomes of these trials are expected to change the landscape of HCC management at all evolutionary stages.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Clin Med Res
                Journal ID (iso-abbrev): J Clin Med Res
                Journal ID (publisher-id): Elmer Press
                Title: Journal of Clinical Medicine Research
                Publisher: Elmer Press
                ISSN (Print): 1918-3003
                ISSN (Electronic): 1918-3011
                Publication date (Print): April 2023
                Publication date (Electronic): 28 April 2023
                Volume: 15
                Issue: 4
                Pages: 200-207
                Affiliations
                [a ]Department of Internal Medicine, UPMC Harrisburg, Harrisburg, PA, USA
                [b ]Department of Internal Medicine, University of the Americas, Quito, Ecuador
                [c ]Department of Internal Medicine, University of Guadalajara, Mexico
                [d ]Department of Internal Medicine, Monterrey Institute of Technology and Higher Studies, Mexico
                [e ]Department of Internal Medicine, University of Baghdad, College of Medicine, Iraq
                [f ]Department of Biomedical Engineering, University of Houston, Houston, TX, USA
                Author notes
                [g ]Corresponding Author: Evelyn Calderon-Martinez, Department of Internal Medicine, UPMC Harrisburg, Harrisburg, PA 17104, USA. Email: calderonmartinezej@ 123456upmc.edu
                Author information
                https://orcid.org/0000-0003-0657-6978
                Article
                DOI: 10.14740/jocmr4902
                PMC ID: 10181349
                PubMed ID: 37187717
                SO-VID: daa017ae-eb6a-44fa-a5a0-7b2b130cb465
                Copyright © Copyright 2023, Calderon-Martinez et al.
                License:

                This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 1 March 2023
                Date accepted : 14 April 2023
                Categories
                Subject: Review

                ScienceOpen disciplines: Medicine
                Keywords: cancer,hepatocellular,survival,mortality
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: cancer, hepatocellular, survival, mortality

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