title: Hepatocellular Carcinoma in Alcoholic Liver Disease: Current Management and Recent Advances.
abstract: Hepatocellular Carcinoma (HCC) is a major healthcare problem. Almost ninety percent of HCCs develops on cirrhosis due to chronic viral hepatitis, Non-Alcoholic Steatohepatitis (NASH) and alcohol abuse. Alcohol itself is defined a strong human carcinogenic agent. Some genetic polymorphisms in alcohol-metabolizing systems and more recently, some sequence variations within the genes coding for patatin-like phospholipase encoding 3 (PNPLA3) and Transmembrane 6 superfamily 2 (TM6SF2), have been found to promote liver fibrosis in alcohol abuse, until HCC development. The current management of HCC is related to tumor burden and liver function and it does not differ in alcoholics, although in alcoholics the surveillance for HCC could be less effective because socioeconomic context, such as the recall policy, the stage at the diagnosis and the prognosis are not different compared to viral HCCs. On regards of loco-regional treatment options, there have not been significant advances in the last few years, though an increasing role will be probably reserved to radio embolization and irreversible electroporation in the next future. Sorafenib (SOR) is still the only drug approved as systemic therapy in patients with HCC, whereas immunotherapy represents a promising approach for the treatment of HCC.
authors.affiliation: Internal Medicine and Hepatology Unit, Campus Bio Medico University of Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Galati
authors.forename: Chiara
authors.initials: C
authors.lastname: Dell'Unto
authors.forename: Umberto
authors.initials: U
authors.lastname: Vespasiani-Gentilucci
authors.forename: Antonio
authors.initials: A
authors.lastname: De Vincentis
authors.forename: Paolo
authors.initials: P
authors.lastname: Gallo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Guidi
authors.forename: Antonio
authors.initials: A
authors.lastname: Picardi
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D008113:Liver Neoplasms / Q000209:etiology* / Q000473:pathology / Q000628:therapy*