Hepatocellular carcinoma.
OBJECTIVE
Our aim is to review the latest information regarding the risk factors, markers for early detection, diagnosis, and therapy for this tumor type.


RESULTS
Alcohol, tobacco, and obesity interact together to increase the risk of hepatocellular carcinoma, which may allow us to identify a high-risk group for hepatocellular carcinoma among patients with cirrhosis. For the first time, a randomized controlled trial of surveillance for hepatocellular carcinoma showed improved survival for those patients who underwent surveillance compared with no surveillance. Another study showed that washout of contrast of an arterially enhancing lesion is sensitive and specific for hepatocellular carcinoma. The Barcelona Clinic Liver Cancer staging classification is the best at stratifying prognosis and treatment strategy for patients with hepatocellular carcinoma. Three randomized trials showed that radiofrequency ablation improves survival when compared to percutaneous ethanol injection for early hepatocellular carcinoma.


CONCLUSIONS
Not all patients with cirrhosis have an equal risk for developing hepatocellular carcinoma. Further studies should stratify the risk of hepatocellular carcinoma so surveillance is tailored to those at the highest risk. Washout of contrast of arterially enhancing mass is regarded as the typical appearance of hepatocellular carcinoma in triple-phase imaging. Radiofrequency ablation is the best ablative technique for the treatment of small hepatocellular carcinoma.
University of Michigan, Ann Arbor, 48109, USA. jmarrero@umich.edu
Jorge A
JA
Marrero
D000465:Algorithms; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D008403:Mass Screening; D011379:Prognosis; D012307:Risk Factors