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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 18, 2015; 7(8): 1020-1029
Published online May 18, 2015. doi: 10.4254/wjh.v7.i8.1020
Hepatocellular carcinoma: From diagnosis to treatment
Abhijeet Waghray, Arvind R Murali, KV Narayanan Menon
Abhijeet Waghray, Department of Medicine, MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH 44109, United States
Arvind R Murali, Department of Gastroenterology and Hepatology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States
KV Narayanan Menon, Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest: The authors have no financial or grant support conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Abhijeet Waghray, MD, Department of Medicine, MetroHealth Medical Center/Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH 44109, United States. awaghray@metrohealth.org
Telephone: +1-216-7787800
Received: September 5, 2014
Peer-review started: September 5, 2014
First decision: November 27, 2014
Revised: January 15, 2015
Accepted: February 10, 2015
Article in press: February 12, 2015
Published online: May 18, 2015
Processing time: 256 Days and 16.5 Hours
Abstract

Hepatocellular carcinoma (HCC) is the sixth most prevalent malignancy worldwide and is a rising cause of cancer related mortality. Risk factors for HCC are well documented and effective surveillance and early diagnosis allow for curative therapies. The majority of HCC appears to be caused by cirrhosis from chronic hepatitis B and hepatitis C virus. Preventive strategies include vaccination programs and anti-viral treatments. Surveillance with ultrasonography detects early stage disease and improves survival rates. Many treatment options exist for individuals with HCC and are determined by stage of presentation. Liver transplantation is offered to patients who are within the Milan criteria and are not candidates for hepatic resection. In patients with advanced stage disease, sorafenib shows some survival benefit.

Keywords: Hepatocellular carcinoma; Hepatitis C virus; Liver transplantation; Tumor ablation; Sorafenib

Core tip: Hepatocellular carcinoma (HCC) is a rising cause of cancer related mortality and viral causes of cirrhosis appear to be a major cause. Surveillance helps to detect early stage disease and treatment options are determined by stage of presentation. Three potentially curative options are radiofrequency ablation, liver transplantation and tumor resection. Emerging therapies such as drug-eluting beads-transarterial chemoembolization or sorafenib will continue to advance treatment options in HCC. The following will provide a concise review of HCC from prevention to treatment.