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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 28, 2015; 7(9): 1157-1167
Published online May 28, 2015. doi: 10.4254/wjh.v7.i9.1157
Hepatocellular carcinoma: Advances in diagnosis, management, and long term outcome
Adam S Bodzin, Ronald W Busuttil
Adam S Bodzin, Ronald W Busuttil, Department of Surgery, University of California, Los Angeles, CA 90095, United States
Author contributions: Bodzin AS and Busuttil RW contributed to this paper.
Conflict-of-interest: None of the authors have received fees for serving as a speaker or consultant, nor have they received research funding in relation to this manuscript or its research.
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: Ronald W Busuttil, MD, PhD, Distinguished Professor and Executive Chairman, Department of Surgery, University of California, 757 Westwood Plaza, Suite 8236, Los Angeles, CA 90095, United States. rbusuttil@mednet.ucla.edu
Telephone: +1-310-2678054 Fax: +1-310-2673668
Received: October 22, 2014
Peer-review started: October 22, 2014
First decision: November 27, 2014
Revised: December 13, 2014
Accepted: March 4, 2015
Article in press: March 5, 2015
Published online: May 28, 2015
Processing time: 210 Days and 7.8 Hours
Abstract

Hepatocellular carcinoma (HCC) remains a common and lethal malignancy worldwide and arises in the setting of a host of diseases. The incidence continues to increase despite multiple vaccines and therapies for viruses such as the hepatitis B and C viruses. In addition, due to the growing incidence of obesity in Western society, there is anticipation that there will be a growing population with HCC due to non-alcoholic fatty liver disease. Due to the growing frequency of this disease, screening is recommended using ultrasound with further imaging using magnetic resonance imaging and multi-detector computed tomography used for further characterization of masses. Great advances have been made to help with the early diagnosis of small lesions leading to potential curative resection or transplantation. Resection and transplantation maybe used in a variety of patients that are carefully selected based on underlying liver disease. Using certain guidelines and clinical acumen patients may have good outcomes with either resection or transplantation however many patients are inoperable at time of presentation. Fortunately, the use of new locoregional therapies has made down staging patients a potential option making them potential surgical candidates. Despite a growing population with HCC, new advances in viral therapies, chemotherapeutics, and an expanding population of surgical and transplant candidates might all contribute to improved long-term survival of these patients.

Keywords: Hepatocellular carcinoma; Transplantation; Survival; Locoregional therapy; Resection

Core tip: Hepatocellular carcinoma (HCC) is a growing malignancy with poor survival. New therapies for the hepatitis C virus may help prevent the development of this malignancy, however the growing obesity epidemic will continue to foster new cases of HCC. With the aid of advances in imaging patients might be diagnosed earlier making them candidates for curative resection or transplantation. In addition, with a growing population of patients undergoing surgery after being down-staged with locoregional therapy, we expect an improvement in long-term outcomes for HCC patients.