Surveillance for hepatocellular carcinoma(HCC)is considered a standard of care for patients with chronic liver disease who are at risk of developing this malignancy.Several studies have shown that surveillance can imp...Surveillance for hepatocellular carcinoma(HCC)is considered a standard of care for patients with chronic liver disease who are at risk of developing this malignancy.Several studies have shown that surveillance can improve the prognosis of patients diagnosed with HCC through an increased likelihood of application of curative or effective treatments.Repetition of liver ultrasonography(US)every 6 mo is the recommended surveillance program to detect early HCCs,and a positive US has to entrain a well-defined recall policy based on contrast-enhanced,dynamic radiological imaging or biopsy for the diagnosis of HCC.Although HCC fulfills the accepted criteria regarding cost-effective cancer screening and surveillance,the implementation of surveillance in clinical practice is defective and this has a negative impact on the cost-effectiveness of the procedure.Education of both physicians and patients is of paramount importance in order to improve the surveillance application and its benefits in patients at risk of HCC.The promotion of specific educational programs for practitioners,clinicians and patients is instrumental in order to expand the correct use of surveillance in clinical practice and eventually improve HCC prognosis.展开更多
Background:Hepatocellular carcinoma(HCC)is one of the most frequent causes of cancer-related death.Sorafenib,a multitarget angiogenesis inhibitor,is an approved frontline treatment for advanced HCC in Western countrie...Background:Hepatocellular carcinoma(HCC)is one of the most frequent causes of cancer-related death.Sorafenib,a multitarget angiogenesis inhibitor,is an approved frontline treatment for advanced HCC in Western countries,although a complete response(CR)to treatment is infrequently reported.Capecitabine,an oral fluoropyrimidine,has been shown to be effect in both treatment-naïve patients and those previously treated with sorafenib.To date,how-ever,only one case of sustained CR to metronomic capecitabine has been reported.Case presentation:We describe three cases of advanced HCC treated with metronomic capecitabine where a CR was obtained.In the first case,capecitabine was administered as first line therapy;in the second case,capecitabine was used after intolerance to sorafenib;while in the third case,capecitabine was administered after sorafenib failure.Conclusion:Capecitabine is a potentially important treatment option for patients with advanced HCC and may even represent a cure in certain cases.展开更多
We were very interested to read the study recently published in Gastroenterology by Moon et al. (1). Performed as a case-control study within the US Veterans Affairs health care system, the study aimed to assess the a...We were very interested to read the study recently published in Gastroenterology by Moon et al. (1). Performed as a case-control study within the US Veterans Affairs health care system, the study aimed to assess the association between screening for hepatocellular carcinoma (HCC) and cancer related-mortality in patients with cirrhosis. The authors did not find any evidence that screening patients with cirrhosis by abdominal ultrasound (US) or alpha-fetoprotein (AFP) levels decreases HCC-related mortality.展开更多
文摘Surveillance for hepatocellular carcinoma(HCC)is considered a standard of care for patients with chronic liver disease who are at risk of developing this malignancy.Several studies have shown that surveillance can improve the prognosis of patients diagnosed with HCC through an increased likelihood of application of curative or effective treatments.Repetition of liver ultrasonography(US)every 6 mo is the recommended surveillance program to detect early HCCs,and a positive US has to entrain a well-defined recall policy based on contrast-enhanced,dynamic radiological imaging or biopsy for the diagnosis of HCC.Although HCC fulfills the accepted criteria regarding cost-effective cancer screening and surveillance,the implementation of surveillance in clinical practice is defective and this has a negative impact on the cost-effectiveness of the procedure.Education of both physicians and patients is of paramount importance in order to improve the surveillance application and its benefits in patients at risk of HCC.The promotion of specific educational programs for practitioners,clinicians and patients is instrumental in order to expand the correct use of surveillance in clinical practice and eventually improve HCC prognosis.
文摘Background:Hepatocellular carcinoma(HCC)is one of the most frequent causes of cancer-related death.Sorafenib,a multitarget angiogenesis inhibitor,is an approved frontline treatment for advanced HCC in Western countries,although a complete response(CR)to treatment is infrequently reported.Capecitabine,an oral fluoropyrimidine,has been shown to be effect in both treatment-naïve patients and those previously treated with sorafenib.To date,how-ever,only one case of sustained CR to metronomic capecitabine has been reported.Case presentation:We describe three cases of advanced HCC treated with metronomic capecitabine where a CR was obtained.In the first case,capecitabine was administered as first line therapy;in the second case,capecitabine was used after intolerance to sorafenib;while in the third case,capecitabine was administered after sorafenib failure.Conclusion:Capecitabine is a potentially important treatment option for patients with advanced HCC and may even represent a cure in certain cases.
文摘We were very interested to read the study recently published in Gastroenterology by Moon et al. (1). Performed as a case-control study within the US Veterans Affairs health care system, the study aimed to assess the association between screening for hepatocellular carcinoma (HCC) and cancer related-mortality in patients with cirrhosis. The authors did not find any evidence that screening patients with cirrhosis by abdominal ultrasound (US) or alpha-fetoprotein (AFP) levels decreases HCC-related mortality.