Hepatocellular carcinoma(HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as...Hepatocellular carcinoma(HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer Staging System remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma.展开更多
Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) share a common route of transmission so that about one third of HIV infected individuals show HCV coinfection. Highly active antiretroviral therapy has of...Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) share a common route of transmission so that about one third of HIV infected individuals show HCV coinfection. Highly active antiretroviral therapy has offered a longer and better life to infected patients. While has removed AIDS-related diseases from the list of most common causes of death their place has been taken by complications of HCV infection, such as cirrhosis, end stage liver disease and hepatocellular carcinoma (HCC). HIV/HCV co-infection requires complex management, especially when HCC is present. Co-infected patients with HCC undergo the same therapeutic protocol as their mono-infected counterparts, but special issues such as interaction between regimens, withdrawal of therapy and choice of immunosuppressive agents, demand a careful approach by specialists. All these issues are analyzed in this minireview.展开更多
The liver is a solid organ with a wide variety of primary benign or malignant tumors as well as metastatic lesions.Surgical resection of these tumors remains the only curative modality.Several limitations,however,do n...The liver is a solid organ with a wide variety of primary benign or malignant tumors as well as metastatic lesions.Surgical resection of these tumors remains the only curative modality.Several limitations,however,do not allow the performance of these operations.This review evaluates the indications and limitations regarding these extended hepatic resections,as well as describing all the manipulations that increase the candidates for such operations.A thorough review of the literature was performed in order to define indications for extended hepatectomy,as well as to present all methods that contribute to increasing the volume of the future remnant liver.The role of portal vein ligation,portal vein embolization,two-stage hepatectomy,and in situ liver transection are evaluated in the setting of indications and results.Extended hepatectomies are a necessity due to oncological reasons.All methods developed in order to increase the volume of the remnant liver are safe and efficient.in situ liver transection is a novel and revolutionary two-step procedure for extended hepatic resections.Further clinical studies are required to estimate long-term results and the oncological basis of this technique.展开更多
文摘Hepatocellular carcinoma(HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer Staging System remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma.
文摘Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) share a common route of transmission so that about one third of HIV infected individuals show HCV coinfection. Highly active antiretroviral therapy has offered a longer and better life to infected patients. While has removed AIDS-related diseases from the list of most common causes of death their place has been taken by complications of HCV infection, such as cirrhosis, end stage liver disease and hepatocellular carcinoma (HCC). HIV/HCV co-infection requires complex management, especially when HCC is present. Co-infected patients with HCC undergo the same therapeutic protocol as their mono-infected counterparts, but special issues such as interaction between regimens, withdrawal of therapy and choice of immunosuppressive agents, demand a careful approach by specialists. All these issues are analyzed in this minireview.
文摘The liver is a solid organ with a wide variety of primary benign or malignant tumors as well as metastatic lesions.Surgical resection of these tumors remains the only curative modality.Several limitations,however,do not allow the performance of these operations.This review evaluates the indications and limitations regarding these extended hepatic resections,as well as describing all the manipulations that increase the candidates for such operations.A thorough review of the literature was performed in order to define indications for extended hepatectomy,as well as to present all methods that contribute to increasing the volume of the future remnant liver.The role of portal vein ligation,portal vein embolization,two-stage hepatectomy,and in situ liver transection are evaluated in the setting of indications and results.Extended hepatectomies are a necessity due to oncological reasons.All methods developed in order to increase the volume of the remnant liver are safe and efficient.in situ liver transection is a novel and revolutionary two-step procedure for extended hepatic resections.Further clinical studies are required to estimate long-term results and the oncological basis of this technique.
