The American Association for the Study of Liver Diseases just confirmed a grade Ⅰ recommendation for hepatocellular carcinoma (HCC) screening despite growing controversy. Why should HCC be an exception in the long li...The American Association for the Study of Liver Diseases just confirmed a grade Ⅰ recommendation for hepatocellular carcinoma (HCC) screening despite growing controversy. Why should HCC be an exception in the long list of other cancers where the feasibility and the efficacy of screening were investigated by randomized trials? Only 12.0% of United States patients are screened, a fact that precludes efficacy, and there are no relevant figures on the benefit-risk ratio. The ethics of belief is a treacherous reef. Screening is not just performing a test, but is a public health issue: a national program is needed to ensure minimal participation, quality controls and evaluation of the results to improve the process. There are also serious concerns regarding undisclosed potential conflicts of interest.展开更多
To the Editor: I read with interest the article by Xi et al. that IL-26 is a novel prognostic factor for hepatocellular carcinoma (HCC) after resection [1]. I have some comments on it.First, investigation of prognosti...To the Editor: I read with interest the article by Xi et al. that IL-26 is a novel prognostic factor for hepatocellular carcinoma (HCC) after resection [1]. I have some comments on it.First, investigation of prognostic factors is only generating hypothesis which must be confirmed in a prospective series.展开更多
Worldwide,the burden of the non viral causes of hepatocellular carcinoma(HCC) is usually underestimated.Clearly industrial goods,tobacco,alcohol and processed foods are the agents of new epidemics in modern times whic...Worldwide,the burden of the non viral causes of hepatocellular carcinoma(HCC) is usually underestimated.Clearly industrial goods,tobacco,alcohol and processed foods are the agents of new epidemics in modern times which far outscore the burden of infectious agents on morbidity and mortality.Smoking,a dose-related contributing factor for HCC,receives too little attention in clinical practice.In France,tobacco,hepatitis B and C virus and alcohol are the main risk factors for HCC mortality(33%,31% and 26%,respectively).In developing countries,where tobacco consumption is dramatically increasing,this epidemic may soon surpass hepatitis B.Obesity and diabetes are the contributing factors too.The role of industrial processed foods in the increase of the prevalence of obesity and diabetes cannot be ignored.展开更多
Glucocorticosteroids have been used as the only treatment for a long time which significantly reduced the mortality of the patients with severe alcoholic hepatitis.The efficacy of transplantation has been recently add...Glucocorticosteroids have been used as the only treatment for a long time which significantly reduced the mortality of the patients with severe alcoholic hepatitis.The efficacy of transplantation has been recently addressed in a pilot study.The result seems promising but needs larger multicenter trials.展开更多
Transplantation cannot be considered the most important therapeutic procedure for hepatocellular carcinoma （HCC）. In France, no more than 2% of patients with HCC undergo a transplantation. Randomized conb＇olled tri...Transplantation cannot be considered the most important therapeutic procedure for hepatocellular carcinoma （HCC）. In France, no more than 2% of patients with HCC undergo a transplantation. Randomized conb＇olled trial must assess the benefit to risk ratio of various potentially ＂curative＂ treatment procedures （transplantation, resection, radiofrequency ablation）.展开更多
文摘The American Association for the Study of Liver Diseases just confirmed a grade Ⅰ recommendation for hepatocellular carcinoma (HCC) screening despite growing controversy. Why should HCC be an exception in the long list of other cancers where the feasibility and the efficacy of screening were investigated by randomized trials? Only 12.0% of United States patients are screened, a fact that precludes efficacy, and there are no relevant figures on the benefit-risk ratio. The ethics of belief is a treacherous reef. Screening is not just performing a test, but is a public health issue: a national program is needed to ensure minimal participation, quality controls and evaluation of the results to improve the process. There are also serious concerns regarding undisclosed potential conflicts of interest.
文摘To the Editor: I read with interest the article by Xi et al. that IL-26 is a novel prognostic factor for hepatocellular carcinoma (HCC) after resection [1]. I have some comments on it.First, investigation of prognostic factors is only generating hypothesis which must be confirmed in a prospective series.
文摘Worldwide,the burden of the non viral causes of hepatocellular carcinoma(HCC) is usually underestimated.Clearly industrial goods,tobacco,alcohol and processed foods are the agents of new epidemics in modern times which far outscore the burden of infectious agents on morbidity and mortality.Smoking,a dose-related contributing factor for HCC,receives too little attention in clinical practice.In France,tobacco,hepatitis B and C virus and alcohol are the main risk factors for HCC mortality(33%,31% and 26%,respectively).In developing countries,where tobacco consumption is dramatically increasing,this epidemic may soon surpass hepatitis B.Obesity and diabetes are the contributing factors too.The role of industrial processed foods in the increase of the prevalence of obesity and diabetes cannot be ignored.
文摘Glucocorticosteroids have been used as the only treatment for a long time which significantly reduced the mortality of the patients with severe alcoholic hepatitis.The efficacy of transplantation has been recently addressed in a pilot study.The result seems promising but needs larger multicenter trials.
文摘Transplantation cannot be considered the most important therapeutic procedure for hepatocellular carcinoma （HCC）. In France, no more than 2% of patients with HCC undergo a transplantation. Randomized conb＇olled trial must assess the benefit to risk ratio of various potentially ＂curative＂ treatment procedures （transplantation, resection, radiofrequency ablation）.
