title: Diagnostic and therapeutic management of hepatocellular carcinoma.
abstract: Hepatocellular carcinoma (HCC) is an increasing health problem, representing the second cause of cancer-related mortality worldwide. The major risk factor for HCC is cirrhosis. In developing countries, viral hepatitis represent the major risk factor, whereas in developed countries, the epidemic of obesity, diabetes and nonalcoholic steatohepatitis contribute to the observed increase in HCC incidence. Cirrhotic patients are recommended to undergo HCC surveillance by abdominal ultrasounds at 6-mo intervals. The current diagnostic algorithms for HCC rely on typical radiological hallmarks in dynamic contrast-enhanced imaging, while the use of α-fetoprotein as an independent tool for HCC surveillance is not recommended by current guidelines due to its low sensitivity and specificity. Early diagnosis is crucial for curative treatments. Surgical resection, radiofrequency ablation and liver transplantation are considered the cornerstones of curative therapy, while for patients with more advanced HCC recommended options include sorafenib and trans-arterial chemo-embolization. A multidisciplinary team, consisting of hepatologists, surgeons, radiologists, oncologists and pathologists, is fundamental for a correct management. In this paper, we review the diagnostic and therapeutic management of HCC, with a focus on the most recent evidences and recommendations from guidelines.
authors.affiliation: Francesco Bellissimo, Marilia Rita Pinzone, Bruno Cacopardo, Giuseppe Nunnari, Department of Clinical and Experimental Medicine, Division of Infectious Diseases, University of Catania, 95100 Catania, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bellissimo
authors.affiliation: Francesco Bellissimo, Marilia Rita Pinzone, Bruno Cacopardo, Giuseppe Nunnari, Department of Clinical and Experimental Medicine, Division of Infectious Diseases, University of Catania, 95100 Catania, Italy.
authors.forename: Marilia Rita
authors.initials: MR
authors.lastname: Pinzone
authors.affiliation: Francesco Bellissimo, Marilia Rita Pinzone, Bruno Cacopardo, Giuseppe Nunnari, Department of Clinical and Experimental Medicine, Division of Infectious Diseases, University of Catania, 95100 Catania, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Cacopardo
authors.affiliation: Francesco Bellissimo, Marilia Rita Pinzone, Bruno Cacopardo, Giuseppe Nunnari, Department of Clinical and Experimental Medicine, Division of Infectious Diseases, University of Catania, 95100 Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nunnari
mesh_terms: D000465:Algorithms; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D019091:Critical Pathways; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Cancer; Chronic hepatitis; Cirrhosis; Hepatitis B virus; Hepatitis C virus; Hepatocellular carcinoma; Liver