Hepatocellular carcinoma.
BACKGROUND
Hepatocellular carcinoma is one of the world's most common malignancies. The aims of the present paper are to review data on (1) epidemiology and screening programmes for the early detection of the tumour and (2) advances in the diagnostic imaging and management.


METHODS
Relevant English language articles, published between January 1985 and December 1997, were reviewed. Articles were identified through Medline search, using the key words 'hepatocellular carcinoma'. Articles cited in the bibliographies of these articles were searched manually.


RESULTS
Hepatocellular carcinoma has a heterogeneous geographical distribution. Although its risk factors have been identified, the efficacy of screening programmes remains uncertain. Imaging has improved substantially with the recent application of dual-phase helical computed tomography and magnetic resonance imaging employing specific contrast agents. The comparative efficacy of conservative therapy and surgical resection is uncertain, since well controlled trials are lacking.


CONCLUSIONS
Hepatocellular carcinoma is commonly a problem of two diseases, the malignancy itself and cirrhosis. This renders treatment rarely curative, even when surgical resection can be applied in a technically successful sense. Liver transplantation could be a definitive treatment but this is plagued by limited donor resources.
Akriviadis
E A
EA
Radiology Department, Hippocration Hospital, Thessaloniki, Greece.
Llovet
J M
JM
Efremidis
S C
SC
Shouval
D
D
Canelo
R
R
Ringe
B
B
Meyers
W C
WC
D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D008403:Mass Screening / Q000379:methods; D015995:Prevalence; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods