Hepatocellular carcinoma--what's new?

Area of Science:

• Hepatology
• Oncology
• Radiology

Background:

• Increasing incidence of hepatocellular carcinoma (HCC) necessitates updated management strategies.
• Metabolic syndrome is an emerging cause of HCC, potentially without requiring cirrhosis.
• Cardiovascular comorbidities increase risks associated with surgical interventions for HCC.

Purpose of the Study:

• To review and summarize recent advancements in HCC diagnosis and treatment.
• To highlight key changes in clinical practice and management guidelines.
• To address evolving challenges in HCC care, including graft allocation and systemic therapy.

Main Methods:

• Review of current literature and clinical guidelines on HCC diagnosis and management.
• Focus on diagnostic imaging techniques, including ultrasound and contrast-enhanced ultrasound.
• Analysis of prognostic markers from tumor biopsy and treatment outcomes.

Main Results:

• Radiological diagnosis refined with emphasis on arterial hypervascularity and late-phase "washout".
• Contrast ultrasound offers reliable characterization and vascular kinetics monitoring.
• Biopsy aids in identifying prognostic features for clinical application.
• Liver transplantation is optimal for early-stage HCC, with evolving allocation rules.
• Sorafenib is the first effective systemic therapy for advanced HCC, with restricted indications.

Conclusions:

• HCC management requires continuous standardization and updates in diagnosis and treatment.
• Advanced imaging and molecular profiling are crucial for personalized HCC care.
• Balancing treatment efficacy with resource limitations, like organ availability, remains a challenge.