Hernandez-Gea V, Turon F, Berzigotti A, Villanueva A. Management of small hepatocellular carcinoma in cirrhosis: Focus on portal hypertension. World J Gastroenterol 2013; 19(8): 1193-1199 [PMID: 23482437 DOI: 10.3748/wjg.v19.i8.1193]
Corresponding Author of This Article
Augusto Villanueva, MD, Hepatocellular Carcinoma Translational Laboratory, Barcelona-Clinic Liver Cancer Group, Institut d’Investigacions Biomediques August Pi i Sunyer, Liver Unit, Hospital Clínic, Villarroel, 170, 08036 Barcelona, Spain. augusto.villanueva@ciberehd.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
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World J Gastroenterol. Feb 28, 2013; 19(8): 1193-1199 Published online Feb 28, 2013. doi: 10.3748/wjg.v19.i8.1193
Management of small hepatocellular carcinoma in cirrhosis: Focus on portal hypertension
Virginia Hernandez-Gea, Fanny Turon, Annalisa Berzigotti, Augusto Villanueva
Virginia Hernandez-Gea, Augusto Villanueva, Hepatocellular Carcinoma Translational Research Laboratory, Barcelona-Clinic Liver Cancer Group, Institut d’Investigacions Biomediques August Pi i Sunyer, Liver Unit, Hospital Clinic, 08036 Barcelona, Spain
Fanny Turon, Annalisa Berzigotti, Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
Annalisa Berzigotti, Augusto Villanueva, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto Carlos III, 08036 Barcelona, Spain
Author contributions: All the authors contributed equally to this manuscript.
Correspondence to: Augusto Villanueva, MD, Hepatocellular Carcinoma Translational Laboratory, Barcelona-Clinic Liver Cancer Group, Institut d’Investigacions Biomediques August Pi i Sunyer, Liver Unit, Hospital Clínic, Villarroel, 170, 08036 Barcelona, Spain. augusto.villanueva@ciberehd.org
Telephone: +34-932-279155 Fax: +34-932-275792
Received: December 10, 2012 Revised: January 17, 2013 Accepted: February 5, 2013 Published online: February 28, 2013
Abstract
The incidence of hepatocellular carcinoma (HCC) is rising worldwide being currently the fifth most common cancer and third cause of cancer-related mortality. Early detection of HCC through surveillance programs have enabled the identification of small nodules with higher frequency, and nowadays account for 10%-15% of patients diagnosed in the West and almost 30% in Japan. Patients with small HCC can be candidates for potential curative treatments: liver transplantation, surgical resection and percutaneous ablation, depending on the presence of portal hypertension and co-morbidities. This review will analyze recent advancements in the clinical management of these individuals, focusing on issues related to the role of portal hypertension, the debate between resection and ablative therapies and the future impact of molecular technologies.
