Clinical guideline SEOM: hepatocellular carcinoma

• J. Sastre ^[1] ; R. Díaz-Beveridge ^[7] ; J. García-Foncillas ^[2] ; R. Guardeño ^[3] ; C. López ^[4] ; R. Pazo ^[5] ; N. Rodriguez-Salas ^[6] ; M. Salgado ^[8] ; A. Salud ^[9] ; J. Feliu ^[6]
  1. [1] Hospital Clínico San Carlos de Madrid

     Hospital Clínico San Carlos de Madrid

     Madrid, España

     
  2. [2] Fundación Jiménez Díaz

     Fundación Jiménez Díaz

     Madrid, España

     
  3. [3] Hospital Universitari de Girona Dr. Josep Trueta

     Hospital Universitari de Girona Dr. Josep Trueta

     Gerona, España

     
  4. [4] Hospital Universitario Marqués de Valdecilla

     Hospital Universitario Marqués de Valdecilla

     Santander, España

     
  5. [5] Hospital Miguel Servet

     Hospital Miguel Servet

     Zaragoza, España

     
  6. [6] Hospital Universitario La Paz

     Hospital Universitario La Paz

     Madrid, España

     
  7. [7] Hospital Universitari I Politècnic la Fe
  8. [8] Complexo Hospitalario de Ourense
  9. [9] Hospital Universitari Arnau de Villanova de Lleida

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 17, Nº. 12, 2015, págs. 988-995
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Dialnet Métricas: 1 Cita
• Resumen

  • Hepatocellular carcinoma (HCC) represents the second leading cause of cancer-related death worldwide. Surveillance with abdominal ultrasound every 6 months should be offered to patients with a high risk of developing HCC: Child-Pugh A–B cirrhotic patients, all cirrhotic patients on the waiting list for liver transplantation, high-risk HBV chronic hepatitis patients (higher viral load, viral genotype or Asian or African ancestry) and patients with chronic hepatitis C and bridging fibrosis. Accurate diagnosis, staging and functional hepatic reserve are crucial for the optimal therapeutic approach. Characteristic findings on dynamic CT/MR of arterial hyperenhancement with “washout” in the portal venous or delayed phase are highly specific and sensitive for a diagnosis of HCC in patients with previous cirrhosis, but a confirmed histopathologic diagnosis should be done in patients without previous evidence of chronic hepatic disease. BCLC classification is the most common staging system used in Western countries. Surgical procedures, local therapies and systemic treatments should be discussed and planned for each patient by a multidisciplinary team according to the stage, performance status, liver function and comorbidities. Surgical interventions remain as the only curative procedures but both local and systemic approaches may increase survival and should be offered to patients without contraindications.