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Liver Cancer-
Consequence of Hepatitis
Liver Cancer
Liver cancer is characterized by the growth or spread of abnormal or
malignant cells in the liver tissue. Hepatocellular carcinoma (HCC) is
the most common form
of liver cancer, and is responsible for about
90 percent of the primary
liver cancers in adults. HCC
is more common
in men than women, but it affects both.
Liver cancer is the sixth most
common cancer in the world and the
third leading cause of cancer-related
deaths globally.
Symptoms may include:
-Weight loss (for no known reason and without trying to lose
weight)
-Ongoing lack of appetite
-Feeling very full after a small meal
-A hard lump on the right side just below the rib cage
-Pain or discomfort between the stomach and rib cage, possibly
around -the right shoulder blade
-Yellow-green color to the skin and whites of the eyes
(jaundice)
-Abdominal swelling from fluid buildup in the abdomen (ascites)
-Itching of the skin
-Unusual tiredness
-Nausea
Clinical Consequences of Chronic HCV Infection:
-Hepatic Fibrosis
-Cirrhosis
-End-Stage Liver Disease/ Liver Transplantation
-Extrahepatic Manifestations
Treatment Guidelines
Liver Biopsy
Histological assessment of the liver, and thus, liver biopsy, is a
cornerstone in the evaluation and management of
patients with
liver disease and has long been considered to be an
integral component
of the clinician’s diagnostic armamentarium. Although
sensitive and
relatively accurate blood tests used to detect and
diagnose liver disease
have now become widely available, it is likely that
liver biopsy will remain
a valuable diagnostic tool.
http://www.aasld.org/practiceguidelines/Documents/Bookmarked%
20Practice%20Guidelines/Liver%20Biopsy.pdf
AASLD
Practice Guidelines: Evaluation of the Patient for Liver
Transplantation
Liver transplantation has had a profound impact on the care of
patients
with end-stage liver disease and is the
most effective treatment for
many patients with acute or chronic liver
failure resulting from a variety
of causes. Before transplantation, patients
with advanced liver disease
usually died within months to years. These
patients now have the
opportunity for extended survival with
excellent quality of life after liver
transplantation. Furthermore, the costs of
liver transplants have
steadily declined in recent years.
http://www.aasld.org/practiceguidelines/Documents/Bookmarked%
20Practice%20Guidelines/Liver%20Transplant.pdf
AASLD
Position Paper: The Management of Acute Liver Failure
Acute liver failure (ALF) is a rare
condition in which rapid deterioration
of liver function results in altered
mentation and coagulopathy in
previously normal individuals. U.S.
estimates are placed at approximately
2,000 cases per year. The most prominent
causes include druginduced
liver injury, viral hepatitis, autoimmune
liver disease and shock or
hypoperfusion; many cases (20%) have no
discernible cause. Acute
liver failure often affects young persons
and carries a high morbidity
and mortality.
http://www.aasld.org/practiceguidelines/Documents/Bookmarked%
20Practice%20Guidelines/acute%20liver%20failure.pdf
Articles
Usefulness of Surveillance Programmes for Early
Diagnosis of Hepatocellular Carcinoma in Clinical Practice
Surveillance programmes (SPs) for hepatocellular carcinoma (HCC)
in patients with cirrhosis intend to diagnose the
tumour in its early
stages when an effective therapy can be applied. The
aims of this study
have been to compare the survival of patients with HCC
being diagnosed
or not in SPs, and to establish a more accurate profile
of the best target
population.
http://www.medscape.com/viewarticle/575922
Targeted Therapy Extends Survival for Liver Cancer
Primary liver cell cancer is increasing in the
U.S. Recent data suggest
that the incidence rate has risen to approximately 5
per 100,000 but
the five-year survival remains suboptimal with 8%
overall survival in
the United States. Thus there is a clear unmet need for
more effective
therapies.Targeted therapy applies designed inhibitors
to target critical
molecular pathways that often inhibit tumor progression
but may not
induce tumor progression. Therefore, time to
progression and overall
survival are the most valid endpoints for assessing
response.
The last decades of research into the
molecular mechanisms of human
malignancy have brought forward new age of targeted
therapy. Key
proteins crucial for the cell growth and survival of
malignant cells are
targeted directly with rationally designed inhibitors
hopefully resulting in
specific antitumor effects. Only
Sorafenib, a
multikinase inhibitor, has
been shown to demonstrate efficacy in extending survival
for patients
with hepatocellular carcinoma for a limited time, and
is FDA approved.
A variety
of combinations of these agents hold the promise of enhancing
therapeutic efficacy for the treatment of HCC. It is
incumbent upon
hepatologists to become familiar with these targeted
therapies to
become familiar with these targeted therapies as they
begin to diagnose
and treat patients in their clinical practices.
For
additional information on risk factors, diagnosis, and screening
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