Hepatocellular carcinoma

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  • Tham khảo sách 'hepatocellular carcinoma – clinical research edited by wan-yee lau', y tế - sức khoẻ, y học thường thức phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả

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  • Harrison's Internal Medicine Chapter 88. Tumors of the Liver and Biliary Tree Hepatocellular Carcinoma Incidence Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. The annual global incidence is about 1 million cases, with a male to female ratio of about 4:1. The incidence rate equals the death rate. In the United States, 19,160 new cases and 16,780 deaths were noted in 2007. The death rate in males in low-incidence countries such as the United States is 1.

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  • Chapter 088. Hepatocellular Carcinoma (Part 6) Hepatocellular Carcinoma: Treatment Most HCC patients have two liver diseases, cirrhosis and HCC, each of which is an independent cause of death. The presence of cirrhosis usually places constraints on resection surgery, ablative therapies, and chemotherapy. Thus patient assessment and treatment planning have to take the severity of the nonmalignant liver disease into account. The clinical management choices for HCC can be complex (Fig. 88-1). The natural history of HCC is highly variable.

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  • Chapter 088. Hepatocellular Carcinoma (Part 7) Local Injection Therapy Numerous agents have been used for local injection into tumors, most commonly, ethanol (PEI). The relatively soft HCC within the hard background of cirrhotic liver allows for injection of large volumes of ethanol into the tumor without diffusion into the hepatic parenchyma or leakage out of the liver. PEI causes direct destruction of cancer cells, but it is not selective for cancer cells and will destroy normal cells in the vicinity. It usually requires multiple injections (average of three), in contrast to one for RFA.

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  • Table 88-5 Some Randomized Clinical Trials Involving Transhepatic Artery Chemoembolization (TACE) for Hepatocellular Carcinoma Yea Agents 1 Agents 2 Surviva l Effect Kawaii 1992 Doxorubici n + embo Embo No Chang 1994 embo Cisplatin + Embo No Hatanaka 1995 Cisplatin, doxorubicin embo Same + ethiodol + No Uchino 1993 Cisplatin, Same + No doxorubicin + oral tamoxifen FU Lin 1988 Embo IV FU Embo + No Yoshikaw a 1994 + Epirubicin ethiodol n Epirubici No (Lipiodol) Pelletier 1990 Doxorubici n + Gelfoam None No Trinchet 1995 Cisplatin + Gelfoam ...

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  • Table 88-6 Some Novel Medical Treatments for Hepatocellular Carcinoma EGF receptor antibody Erlotinib, Gefitinib Kinase antagonists, Sorafenib Vitamin K IL-2 131 I – ethiodol (Lipiodol) 131 I – Ferritin 90 Yttrium microspheres 166 Holmium Three-dimensional conformal radiation Proton beam high-dose radiotherapy Anti-angiogenesis strategies, Bevacizumab Note: EGF, epidermal growth factor; IL, interleukin. Summary Most Common Modes of Patient Presentation 1.

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  • Approach to the Patient: Hepatocellular Carcinoma History and Physical The history is important in evaluating putative predisposing factors, including a history of hepatitis or jaundice, blood transfusion, or use of intravenous drugs. A family history of HCC or hepatitis should be sought, and a detailed social history taken to include job descriptions for industrial exposure to possible carcinogenic drugs as well as contraceptive hormones.

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  • Carcinoma of the Ampulla of Vater This tumor arises within 2 cm of the distal end of the common bile duct, and is mainly (90%) an adenocarcinoma. Locoregional lymph nodes are commonly involved (50%), and the liver is the most frequent site for metastases. The commonest clinical presentation is jaundice, and many patients also have pruritus, weight loss, and epigastric pain. Initial evaluation is performed with an abdominal ultrasound to assess vascular involvement, biliary dilatation, and liver lesions. This is followed by a CT scan, or MRI and especially MRCP.

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  • Hepatocellular carcinoma (HCC) is a major cause of cancer mortality worldwide. Because early detection is rare, the overall prognosis is generally poor. Understanding of the etiology, epidemiology, pathophysiology, molecular biology, and clinical features of HCC is important in providing optimal patient care. In addition, understanding of the limitations of our current knowledge and therapeutic capabilities is essential in order to guide future research efforts.

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Targeting the inflammation in HCV-associated hepatocellular carcinoma: a role in the prevention and treatment

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  • Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P32 provides a detailed repository of the latest information regarding HCC epidemiology, diagnosis, imaging, pathology, staging, and treatment options.

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  • Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P35 provides a detailed repository of the latest information regarding HCC epidemiology, diagnosis, imaging, pathology, staging, and treatment options.

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  • Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P6 provides a detailed repository of the latest information regarding HCC epidemiology, diagnosis, imaging, pathology, staging, and treatment options.

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  • Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P15 provides a detailed repository of the latest information regarding HCC epidemiology, diagnosis, imaging, pathology, staging, and treatment options.

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  • Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P24 provides a detailed repository of the latest information regarding HCC epidemiology, diagnosis, imaging, pathology, staging, and treatment options.

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  • Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P30 provides a detailed repository of the latest information regarding HCC epidemiology, diagnosis, imaging, pathology, staging, and treatment options.

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  • Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P31 provides a detailed repository of the latest information regarding HCC epidemiology, diagnosis, imaging, pathology, staging, and treatment options.

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  • Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P34 provides a detailed repository of the latest information regarding HCC epidemiology, diagnosis, imaging, pathology, staging, and treatment options.

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  • Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P39 provides a detailed repository of the latest information regarding HCC epidemiology, diagnosis, imaging, pathology, staging, and treatment options.

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  • Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P41 provides a detailed repository of the latest information regarding HCC epidemiology, diagnosis, imaging, pathology, staging, and treatment options.

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