title: Diagnosis and treatment of hepatocellular carcinoma: An update.
abstract: Hepatocellular carcinoma (HCC) is one of the most common malignancies leading to high mortality rates in the general population; in cirrhotic patients, it is the primary cause of death. The diagnosis is usually delayed in spite of at-risk population screening recommendations, i.e., patients infected with hepatitis B or C virus. Hepatocarcinogenesis hinges on a great number of genetic and molecular abnormalities that lead to tumor angiogenesis and foster their dissemination potential. The diagnosis is mainly based on imaging studies such as computed tomography and magnetic resonance, in which lesions present a characteristic classical pattern of early arterial enhancement followed by contrast medium "washout" in late venous phase. On occasion, when imaging studies are not conclusive, biopsy of the lesion must be performed to establish the diagnosis. The Barcelona Clinic Liver Cancer staging method is the most frequently used worldwide and recommended by the international guidelines of HCC management. Currently available treatments include tumor resection, liver transplant, sorafenib and loco-regional therapies (alcoholization, radiofrequency ablation, chemoembolization). The prognosis of hepatocarcinoma is determined according to the lesion's stage and in cirrhotic patients, on residual liver function. Curative treatments, such as liver transplant, are sought in patients diagnosed in early stages; patients in more advanced stages, were not greatly benefitted by chemotherapy in terms of survival until the advent of target molecules such as sorafenib.
authors.affiliation: Javier Tejeda-Maldonado, Diego Luis Carrillo-Pérez, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000 Mexico City, Mexico.
authors.forename: Javier
authors.initials: J
authors.lastname: Tejeda-Maldonado
authors.affiliation: Javier Tejeda-Maldonado, Diego Luis Carrillo-Pérez, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000 Mexico City, Mexico.
authors.forename: Ignacio
authors.initials: I
authors.lastname: García-Juárez
authors.affiliation: Javier Tejeda-Maldonado, Diego Luis Carrillo-Pérez, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000 Mexico City, Mexico.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Aguirre-Valadez
authors.affiliation: Javier Tejeda-Maldonado, Diego Luis Carrillo-Pérez, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000 Mexico City, Mexico.
authors.forename: Adrián
authors.initials: A
authors.lastname: González-Aguirre
authors.affiliation: Javier Tejeda-Maldonado, Diego Luis Carrillo-Pérez, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000 Mexico City, Mexico.
authors.forename: Mario
authors.initials: M
authors.lastname: Vilatobá-Chapa
authors.affiliation: Javier Tejeda-Maldonado, Diego Luis Carrillo-Pérez, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000 Mexico City, Mexico.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Armengol-Alonso
authors.affiliation: Javier Tejeda-Maldonado, Diego Luis Carrillo-Pérez, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000 Mexico City, Mexico.
authors.forename: Francisco
authors.initials: F
authors.lastname: Escobar-Penagos
authors.affiliation: Javier Tejeda-Maldonado, Diego Luis Carrillo-Pérez, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000 Mexico City, Mexico.
authors.forename: Aldo
authors.initials: A
authors.lastname: Torre
authors.affiliation: Javier Tejeda-Maldonado, Diego Luis Carrillo-Pérez, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000 Mexico City, Mexico.
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Sánchez-Ávila
authors.affiliation: Javier Tejeda-Maldonado, Diego Luis Carrillo-Pérez, Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14000 Mexico City, Mexico.
authors.forename: Diego Luis
authors.initials: DL
authors.lastname: Carrillo-Pérez
keywords: Catheter ablation; Hepatocellular carcinoma; Liver transplant; Sorafenib; Surveillance
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