Hepatocellular carcinoma: ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Annals of Oncology (Impact Factor: 7.04). 09/2012; 23(suppl 7):vii41-vii48. DOI: 10.1093/annonc/mds225
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    ABSTRACT: Increasing noncoding RNAs (ncRNAs) were found to show abnormal expression patterns in various human cancers. Based on their length, ncRNAs are briefly divided into two categories. Transcripts that are shorter than 200 nucleotides are recognized as short/small noncoding RNAs and greater than 200 nucleotides as long noncoding RNAs (lncRNAs). Short/small noncoding RNAs include microRNAs, piRNAs, snoRNAs, and endogenous siRNAs. Numerous studies have revealed that these short/small ncRNA play important roles in multiple biological processes and tumorigenesis. In contrast to small ncRNAs, long noncoding RNAs are much less known concerning their functions in human cancers especially in hepatocellular carcinoma (HCC). In this review, we highlight recent progress regarding HCC development, tumorigenesis, metastasis, clinical implication, as well as the role in the risk of HBV infection.
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    ABSTRACT: Hepatocellular carcinoma (HCC) is a highly prevalent and lethal neoplasia. Current data show that it is the main cause of death in patients with cirrhosis. A better knowledge of the natural history of the tumor and the development of staging systems have led to a better prediction of prognosis and to a most appropriate treatment approach. The Barcelona Clinic Liver Cancer (BCLC) system has become the preferred staging system since it takes into account the characteristics of the tumor, the degree of liver impairment and the physical performance. In addition, it is the only one that links prognosis assessment with treatment recommendation. Curative therapies such as resection, transplantation and ablation can improve survival in patients diagnosed at an early HCC stage and may offer a long-term cure. Patients with intermediate-stage HCC benefit from chemoembolization and those diagnosed at an advanced stage benefit from sorafenib, an oral available, multikinase inhibitor with antiangiogenic and antiproliferative effects. Further efforts are needed to improve the survival of this lethal neoplasia.
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