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Hepatocellular Carcinoma in Adults and Children, An Issue of Clinics in Liver Disease, E-Book

Hepatocellular Carcinoma in Adults and Children, An Issue of Clinics in Liver Disease, E-Book

Adrian Reuben

(2015)

Additional Information

Abstract

Dr. Reuben provides a timely update to the topic of HCC, which was last covered in 2011. The highly respected authors in his issue address advances in imaging for diagnosis, surgical resection and liver transplantation, and local and systemic therapy. The breadth of the topic is covered, with articles devoted to histopathology, classification and staging, and screening and detection.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Hepatocellular Carcinoma in \rAdults and Children i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents vii
Preface: Hepatocellular Carcinoma in Adults and Children\r vii
Global Epidemiology of Hepatocellular Carcinoma: An Emphasis on Demographic and Regional Variability\r vii
Anatomic Pathology of Hepatocellular Carcinoma: Histopathology Using Classic and New Diagnostic Tools\r vii
Pathogenesis and Prognosis of Hepatocellular Carcinoma at the Cellular and Molecular Levels\r vii
Classification and Staging of Hepatocellular Carcinoma: An Aid to Clinical Decision-Making\r viii
Screening and Detection of Hepatocellular Carcinoma\r viii
Elevated Alpha-Fetoprotein: Differential Diagnosis - Hepatocellular Carcinoma and Other Disorders\r viii
Imaging of Hepatocellular Carcinoma: New Approaches to Diagnosis\r viii
Oncogenic Viruses and Hepatocellular Carcinoma\r ix
Nonalcoholic Fatty Liver Disease, Diabetes, Obesity, and Hepatocellular Carcinoma\r ix
Surgical Resection and Liver Transplantation for Hepatocellular Carcinoma\r ix
Locoregional Therapy of Hepatocellular Carcinoma\r ix
Systemic Therapy of Hepatocellular Carcinoma: Current and Promising\r x
Hepatocellular Carcinoma in Children\r x
CLINICS IN LIVER DISEASE\r xi
FORTHCOMING ISSUES xi
August 2015 xi
November 2015 xi
February 2016 xi
RECENT ISSUES xi
February 2015 xi
November 2014 xi
August 2014 xi
Preface: Hepatocellular Carcinoma in Adults and Children \r xiii
REFERENCES xvi
Global Epidemiology of Hepatocellular Carcinoma 223
Key points 223
INTRODUCTION 223
INCIDENCE AND MORTALITY 224
Gender and Racial/Ethnic Differences in Rates 226
HEPATOCELLULAR CARCINOMA RISK FACTORS AND PREVENTION 226
Hepatitis B Virus 227
Hepatitis C Virus 228
Aflatoxin 229
Alcohol Consumption 229
Obesity, Diabetes Mellitus, and Metabolic Syndrome 230
Tobacco 230
Coffee and Tea 230
CHEMOPREVENTION 231
Statins 231
Antidiabetic Medications 231
Aspirin 231
SUMMARY 232
REFERENCES 232
Anatomic Pathology of Hepatocellular Carcinoma 239
Key points 239
INTRODUCTION 239
CLINICAL DATA 239
HEMATOXYLIN-EOSIN STAIN EVALUATION OF THE DIRECTED BIOPSY FOR HEPATOCELLULAR CARCINOMA 240
Liver Biopsy in Hepatocellular Carcinoma: Yes or No? 240
Architecture 240
Cytology 240
Stroma 242
FURTHER WORK-UP OF SUSPECTED HEPATOCELLULAR CARCINOMA 246
Scenario 1: Metastasis Versus Primary Liver Carcinoma 247
Scenario 2: Hepatocellular Carcinoma Versus Other Hepatocellular Lesion 249
Scenario 3: Primary Liver Carcinoma Versus Mixed Hepatobiliary-Biphenotypic Carcinoma 251
PRECURSOR LESIONS AND EARLY HEPATOCELLULAR CARCINOMA IN CIRRHOSIS 253
Dysplastic Foci and Nodules 253
Small Hepatocellular Carcinoma 255
SUMMARY 257
REFERENCES 257
Pathogenesis and Prognosis of Hepatocellular Carcinoma at the Cellular and Molecular Levels 261
Key points 261
INTRODUCTION 261
PREDICTING TUMOR BEHAVIOR: A HIGH-THROUGHPUT APPROACH 262
CELL OF ORIGIN AND THE DIVERSITY IN HEPATOCELLULAR CARCINOMAS 265
PLASTICITY OF HEPATOCELLULAR CARCINOMA DEPENDS ON THE MICROENVIRONMENT 266
STEMNESS, A WAY TO SURVIVE IN A HOSTILE ENVIRONMENT 270
SUMMARY 271
REFERENCES 271
Classification and Staging of Hepatocellular Carcinoma 277
Key points 277
INTRODUCTION 277
COMMON CLASSIFICATION AND STAGING METHODS 278
Tumor-Node-Metastasis Classification 278
Okuda Classification 279
Cancer of the Liver Italian Program 279
Japan Integrated Staging 280
Barcelona Clinic Liver Cancer Staging 281
Hong Kong Liver Cancer Prognostic Staging Scheme 283
SELECTING TREATMENT MODALITIES BASED ON STAGE OF HEPATOCELLULAR CARCINOMA 283
Liver Transplantation 285
Surgical Resection 286
Local Ablation Methods 287
Radiotherapy: Stereotactic Body Radiation Therapy and Proton Beam Therapy 287
Catheter-Based Treatments: Transarterial Chemoembolization, Transarterial Radioembolization, and Transarterial Chemoinfusion 288
Systemic Chemotherapy 289
Palliative Care 289
DISCUSSION 289
SUMMARY 291
REFERENCES 291
Screening and Detection of Hepatocellular Carcinoma 295
Key points 295
ROLE OF SCREENING FOR HEPATOCELLULAR CARCINOMA 295
DEFINITION OF THE AT-RISK POPULATION 296
SURVEILLANCE TESTS 296
SCREENING INTERVAL 298
ROLE OF ALPHA FETOPROTEIN IN SCREENING 298
DIAGNOSIS OF HEPATOCELLULAR CARCINOMA 298
IMAGING MODALITIES 299
NEED FOR NEEDLE BIOPSY/LIMITATIONS 299
SAFETY OF BIOPSY/RISK OF SEEDING 300
ROLE OF CURRENTLY USED TUMOR MARKERS IN HEPATOCELLULAR CARCINOMA DIAGNOSIS 300
Alpha Fetoprotein 300
Les Culinaris Agglutinin-Reactive Alpha Fetoprotein 301
Des-Gamma Carboxy Prothrombin 301
Newer Tumor Markers 301
SUMMARY 302
REFERENCES 302
Elevated Alpha-Fetoprotein 309
Key points 309
INTRODUCTION 310
SURVEILLANCE FOR HEPATOCELLULAR CARCINOMA 310
Evolution of Surveillance Guidelines 310
Worldwide Variation in Hepatocellular Carcinoma Surveillance Guidelines 311
SERUM ALPHA-FETOPROTEIN 311
Causes of Elevation in Serum Alpha-Fetoprotein Level 311
Factors Impacting Serum Alpha-Fetoprotein Level as a Tumor Marker 312
The Role of Serum Alpha-Fetoprotein in Hepatocellular Carcinoma Surveillance 313
The Role of Alpha-Fetoprotein in Predicting Hepatic Fibrosis 314
The Role of Alpha-Fetoprotein in Modeling to Predict Hepatocellular Carcinoma 315
Serum Alpha-Fetoprotein Level and Liver Transplantation 315
RISK BIOMARKERS FOR HEPATOCELLULAR CARCINOMA 316
Lens culinaris Agglutinin-Reactive Alpha-Fetoprotein 316
Des-Y-Carboxyprothrombin 316
Improved Risk Assessment with an Expanded Biomarker Panel with Alpha-Fetoprotein 316
INVESTIGATIONAL TUMOR MARKERS 318
Glypican-3 318
SUMMARY 318
REFERENCES 319
Imaging of Hepatocellular Carcinoma 325
Key points 325
INTRODUCTION 325
American Association for the Study of Liver Diseases-Organ Procurement and Transplant Network Criteria for Hepatocellular C ... 326
Summary 327
LIVER IMAGING REPORTING AND DATA SYSTEM 327
Major Features Described in Liver Imaging Reporting and Data System 328
Arterial phase enhancement 328
Diameter 329
Washout 329
Capsule 330
Threshold growth 330
Ancillary features 330
LIVER IMAGING REPORTING AND DATA SYSTEM 1 331
Summary 331
LIVER IMAGING REPORTING AND DATA SYSTEM 2 332
Oncogenic Viruses and Hepatocellular Carcinoma 341
Key points 341
INTRODUCTION 341
PATHOGENESIS 342
Hepatitis B Virus 342
Hepatitis B Virus DNA Viral Integration into the Host's Genome 343
Alterations in the transcriptional levels of adjacent genes 343
Genome instability 343
Viral-human fusion transcripts 343
HBx 343
Epigenetic effects 343
MicroRNA 344
Apoptosis 345
DNA repair pathways and genetic instability 345
Hepatitis C Virus 345
Core protein 345
NS3 346
NS5A 347
NS5B 347
MicroRNAs and hepatitis C virus–associated cancer 347
RISK OF HEPATOCELLULAR CARCINOMA IN A NONCIRRHOTIC LIVER 347
Hepatitis B Virus 347
Occult Hepatitis B Virus 348
Hepatitis C Virus 348
PREVENTION OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH CHRONIC VIRAL HEPATITIS B AND C 349
Hepatitis B Virus Vaccine 349
Hepatitis B Virus Antiviral Therapy: Interferon and Nucleoside/Nucleotide Analogues 349
Interferon-α therapy 349
Nucleoside/Nucleotide analogues 350
Hepatitis C Virus Antiviral Therapy 350
Risk for Hepatocellular Carcinoma Development in Patients Without Cirrhosis After Successful Antiviral Therapy 351
Advanced fibrosis/patients with cirrhosis achieving sustained viral response and risk for hepatocellular carcinoma 351
REFERENCES 352
Nonalcoholic Fatty Liver Disease, Diabetes, Obesity, and Hepatocellular Carcinoma 361
Key points 361
INTRODUCTION 361
OBESITY, DIABETES, NONALCOHOLIC FATTY LIVER DISEASE, AND NONALCOHOLIC STEATOHEPATITIS AS RISK FACTORS FOR HEPATOCELLULAR CA ... 362
HEPATOCELLULAR CARCINOMA IN NONALCOHOLIC FATTY LIVER DISEASE WITHOUT CIRRHOSIS 365
PATHOGENESIS OF HEPATOCELLULAR CARCINOMA IN OBESITY, DIABETES, AND NONALCOHOLIC FATTY LIVER DISEASE 367
Insulin Resistance 368
c-Jun amino-terminal kinases 369
Endoplasmic Reticulum Stress 369
Leptin 370
S-Adenosylmethionine 370
Toll-Like Receptors 371
Potential Chemoprevention of Hepatocellular Carcinoma in Obesity and Nonalcoholic Fatty Liver Disease 371
Statins 371
Metformin 372
S-Adenosylmethionine 372
SUMMARY 373
REFERENCES 373
Surgical Resection and Liver Transplantation for Hepatocellular Carcinoma 381
Key points 381
HEPATIC RESECTION FOR HEPATOCELLULAR CARCINOMA 381
Patient Evaluation 382
Outcome of Hepatic Resection 386
Management of Tumor Recurrence 388
Surgical Techniques 388
LIVER TRANSPLANTATION FOR HEPATOCELLULAR CARCINOMA 389
The Milan Criteria 389
The University of California at San Francisco Criteria 389
Beyond the University of California at San Francisco Criteria 390
Priority Allocation for Hepatocellular Carcinoma Candidates 390
The Role of Pretransplant Ablative Therapy 392
Downstaging for Hepatocellular Carcinoma 393
Living Donor Liver Transplant for Hepatocellular Carcinoma 393
HOW THE AUTHORS DO IT 394
REFERENCES 395
Locoregional Therapy of Hepatocellular Carcinoma 401
Key points 401
INTRODUCTION 401
DIAGNOSTIC APPROACH TO LOCOREGIONAL THERAPY 403
ENDOVASCULAR EMBOLOTHERAPIES 403
Transarterial Chemoembolization 409
Radioembolization 411
ABLATIVE THERAPIES 412
Radiofrequency Ablation 412
Microwave Ablation 412
Irreversible Electroporation 413
Cryoablation 413
Percutaneous Ethanol Injection 413
Locoregional therapy as bridge to transplantation 413
SUMMARY 413
REFERENCES 414
Systemic Therapy of Hepatocellular Carcinoma 421
Key points 421
SYSTEMIC THERAPY FOR HEPATOCELLULAR CARCINOMA 421
SORAFENIB 422
Combination of Sorafenib with Locoregional Therapy or Resection 424
Sorafenib in the Pretransplant Setting 425
Sorafenib Combined with Other Agents 426
Sorafenib and Mammalian Targets of Rapamycin 426
Beyond Sorafenib 426
SUNITINIB 426
BRIVANIB 427
Mammalian Target of Rapamycin Pathway 428
c-Met 428
Antiangiogenesis 428
Personalized Approach in Hepatocellular Carcinoma 429
SUMMARY 429
REFERENCES 429