Research articleDiagnosis and staging of hepatocellular carcinoma (HCC): current guidelines
Section snippets
Surveillance of HCC
Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality, and it is a major cause of death in patients with cirrhosis [1]. The incidence of HCC has been increasing in the last 40 years, and the associated mortality is still increasing in the United States and Canada [2], mainly due to the high prevalence of chronic hepatitis C, and the current epidemic of nonalcoholic steatohepatitis (NASH) that may overlap with excessive alcohol intake. HCC has all the requirements needed
Diagnosis of HCC
The recognition of a nodule > 10 mm by US in livers of patients at high risk for HCC should be followed by diagnostic dynamic CT or MR (Fig. 1). Neoangiogenesis develops actively in small lesions (10–20 mm), resulting in stronger lesion arterial vascularization compared to the surrounding liver parenchyma (wash-in). Simultaneously, a progressive decrease of the portal supply takes place and leads to a decrease of portal blood within the lesion compared to the surrounding liver parenchyma in
Clinical staging and treatment
The Barcelona Clinic Liver Cancer (BCLC) staging system links prognosis of HCC with the best treatment option based on strong clinical evidence [63]. It has been endorsed by scientific associations and many other research groups. It takes into account the most relevant independent prognostic factors influencing survival in patients with HCC: the performance status, the liver function, and the tumor burden (Fig. 9). It has been validated and provides a first allocation of an individual patient
Conflict of interest
The authors report no conflict of interest.
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