Article

Epidemiology of Hepatocellular Carcinoma

Epidemiology and Cancer Registration Unit, IDIBELL, Institut Català d'Oncologia, Avda. Gran Via s/n, Km 2.7, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
Clinics in Liver Disease (Impact Factor: 3.66). 06/2005; 9(2):191-211, v. DOI: 10.1016/j.cld.2004.12.009
Source: PubMed

ABSTRACT

Year 2000 estimates of the incidence of cancer indicate that primary liver cancer remains the fifth most common malignancy in men and the eighth in women. The number of new cases has been predicted as 564,000, corresponding to 398,000 in men and 166,000 in women. The geographic areas at highest risk are located in Eastern Asia, Middle Africa, and some countries of Western Africa. Changes in incidence among migrant populations underline the predominant role of environmental factors in the etiology of primary liver cancer. In high-risk countries, the early cases of primary liver cancer occur already at ages 20 and above, underlying the impact of viral exposures early in life. In countries at low risk, primary liver cancer is rare before the 50s, translating the impact of late exposures with moderate risks and long latency intervals. Sex ratios are typically between 2 and 4. The incidence of primary liver cancer is increasing in several developed countries including the United States, and the increase will likely continue for several decades. The trend has a dominant cohort effect related to exposures to hepatitis B and C viruses. The variability of primary liver cancer incidence is largely explained by the distribution and the natural history of the hepatitis B and C viruses. The attributable risk estimates for the combined effects of these infections account for well over 80% of liver cancer cases worldwide. Primary liver cancer is the first human cancer largely amenable to prevention using hepatitis B virus vaccines and screening of blood and blood products for hepatitis B and C viruses.

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    • "Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the third most common cause of cancer-related deaths [1]. Furthermore, HCC is currently the leading cause of death among patients with liver cirrhosis [2]. "
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    ABSTRACT: Transarterial chemoembolization (TACE) is usually followed by hepatic dysfunction. We evaluated the effects of L-carnitine on post-TACE impaired liver functions. Methods . 53 cirrhotic hepatocellular carcinoma patients at Osaka Medical College were enrolled in this study and assigned into either L-carnitine group receiving 600 mg oral L-carnitine daily or control group. Liver functions were evaluated at pre-TACE and 1, 4, and 12 weeks after TACE. Results . The L-carnitine group maintained Child-Pugh (CP) score at 1 week after TACE and exhibited significant improvement at 4 weeks after TACE ( P < 0.01 ). Conversely, the control group reported a significant CP score deterioration at 1 week ( P < 0.05 ) and 12 weeks after TACE ( P < 0.05 ). L-carnitine suppressed serum albumin deterioration at 1 week after TACE. There were significant differences between L-carnitine and control groups regarding mean serum albumin changes from baseline to 1 week ( P < 0.05 ) and 4 weeks after TACE ( P < 0.05 ). L-carnitine caused prothrombin time improvement from baseline to 1, 4 ( P < 0.05 ), and 12 weeks after TACE. Total bilirubin mean changes from baseline to 1 week after TACE exhibited significant differences between L-carnitine and control groups ( P < 0.05 ). The hepatoprotective effects of L-carnitine were enhanced by branched chain amino acids combination. Conclusion . L-carnitine maintained and improved liver functions after TACE.
    Full-text · Article · Dec 2015 · Mediators of Inflammation
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    • "Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death worldwide and the leading cause of death in patients with the complication of cirrhosis [1] [2]. The occurrence of HCC is larvaceous and short of specific symptoms [3] [4]. "
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    ABSTRACT: . Hepatocellular carcinoma (HCC) is a highly aggressive malignancy. Traditional Chinese Medicine (TCM), with the characteristics of syndrome differentiation, plays an important role in the comprehensive treatment of HCC. This study aims to develop a nonnegative matrix factorization- (NMF-) based feature selection approach (NMFBFS) to identify potential clinical symptoms for HCC patient stratification. Methods . The NMFBFS approach consisted of three major steps. Firstly, statistics-based preliminary feature screening was designed to detect and remove irrelevant symptoms. Secondly, NMF was employed to infer redundant symptoms. Based on NMF-derived basis matrix, we defined a novel similarity measurement of intersymptoms . Finally, we converted each group of redundant symptoms to a new single feature so that the dimension was further reduced. Results . Based on a clinical dataset consisting of 407 patient samples of HCC with 57 symptoms, NMFBFS approach detected 8 irrelevant symptoms and then identified 16 redundant symptoms within 6 groups. Finally, an optimal feature subset with 39 clinical features was generated after compressing the redundant symptoms by groups. The validation of classification performance shows that these 39 features obviously improve the prediction accuracy of HCC patients. Conclusions . Compared with other methods, NMFBFS has obvious advantages in identifying important clinical features of HCC.
    Full-text · Article · Nov 2015 · Computational and Mathematical Methods in Medicine
    • "Hepatocellular carcinoma (HCC) is the most common primary liver cancer, the sixth most common cancer, and the third most common cause of cancer-related deaths in the world [1] [2]. This cancer generally develops secondarily to an underlying chronic liver disease, due to different aetiologies (B or C viral hepatitis, alcohol abuse, non-alcoholic steatohepatitis, genetic iron overload ) [3]. "
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    ABSTRACT: BACKGROUND & AIMS: Transarterial chemoembolization (TACE) is the standard of care for intermediate stage hepatocellular carcinoma (HCC) and it is the most commonly used treatment for HCC worldwide. However, no prognostic indices, designed to select appropriate candidates for repeat conventional TACE, have been incorporated in the guidelines. METHODS: From January 2007 to April 2012, 139 consecutive HCC patients, mainly with an alcohol- or viral-induced disease, were treated with TACE. Using a regression model on the prognostic variables of our population, we determined a score designed to help for repeat TACE and we validated it in two cohorts. We also compared it to the ART score. RESULTS: In the multivariate analysis, four prognostic factors were associated with overall survival: BCLC and AFP (>200ng/ml) at baseline, increase in Child-Pugh score by ⩾2 from baseline, and absence of radiological response. These factors were included in a score (ABCR, ranging from -3 to +6), which correlates with survival and identifies three groups. The ABCR score was validated in two different cohorts of 178 patients and proofed to perform better than the ART score in distinguishing between patients' prognosis. CONCLUSIONS: The ABCR score is a simple and clinically relevant index, summing four prognostic variables endorsed in HCC. An ABCR score ⩾4 prior to the second TACE identifies patients with dismal prognosis who may not benefit from further TACE sessions. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
    No preview · Article · Feb 2015 · Journal of Hepatology
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