Related Experiment Video
Updated: Jun 11, 2026
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Hepatocellular carcinoma: A global view
Ju Dong Yang1, Lewis R Roberts
1Miles and Shirley Fiterman Center for Digestive Diseases, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Insights
Hepatocellular carcinoma (HCC) significantly impacts developing nations, primarily due to chronic hepatitis B (HBV) and hepatitis C (HCV) infections. Management strategies must adapt to resource availability, prioritizing prevention and accessible treatments in low-resource settings.
Area of Science:
- Hepatology and Oncology
- Global Health
- Infectious Diseases
Background:
- Hepatocellular carcinoma (HCC) poses a significant global health challenge, disproportionately affecting developing countries.
- Over 80% of HCC cases occur in low- and middle-income regions, with chronic HBV and HCV infections as primary drivers.
- Early viral transmission leads to HCC in productive adult years, creating a substantial economic and healthcare burden.
Purpose of the Study:
- To outline distinct management strategies for Hepatocellular Carcinoma (HCC) based on resource availability.
- To emphasize primary prevention and accessible treatment options in resource-limited settings.
- To advocate for infrastructure development and cost-effective therapies for HCC.
Main Methods:
- Review of global HCC epidemiology and etiological factors (HBV, HCV).
- Analysis of healthcare resource disparities and their impact on HCC management.
- Comparison of high-resource guidelines with needs in low- and middle-income countries.
Main Results:
- High-resource settings can implement AASLD/EASL guidelines.
- Low- and middle-income settings require a focus on primary prevention (HBV vaccination, precautions, antivirals).
- Development of infrastructure for diagnostics (ultrasonography) and treatments (PEI, RFA, resection) is crucial.
Conclusions:
- Optimal HCC management necessitates tailored strategies considering local resources.
- Prioritizing primary prevention and accessible, low-cost targeted therapies is vital for resource-limited regions.
- Establishing essential healthcare infrastructure is key to reducing the HCC burden globally.
Abstract:
Hepatocellular carcinoma (HCC) is a global health problem, although developing countries are disproportionally affected: over 80% of HCCs occur in such regions. About three-quarters of HCCs are attributed to chronic HBV and HCV infections. In areas endemic for HCV and HBV, viral transmission occurs at an early age, and infected individuals develop HCC in mid-adulthood. As these are their most productive years of life, HCC accounts for a substantial burden on the health-care system and drain of productive capacity in the low-income and middle-income countries most affected by HCV and HBV infections. Environments with disparate resource levels require different strategies for the optimal management of HCC. In high-resource environments, guidelines from the American Association for the Study of Liver Diseases or European Association for the Study of the Liver should be applied. In intermediate-resource or low-resource environments, the fundamental focus should be on primary prevention of HCC, through universal HBV vaccination, taking appropriate precautions and antiviral treatments. In intermediate-resource and low-resource environments, the infrastructure and capacity for abdominal ultrasonography, percutaneous ethanol injection, radiofrequency ablation and surgical resection should be established. Programs to provide targeted therapy at low cost, similar to the approach used for HIV therapy in the developing world, should be pursued.
Related Concept Videos
01:23Cirrhosis I: Introduction
01:25Hepatitis
01:28Viral Hepatitis I: Introduction
01:26Diseases of the Liver and Gallbladder
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
01:24Cirrhosis II: Pathophysiology
01:21Hepatic Portal System
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is responsible...