Hepatocellular carcinoma （HCC） is the most common primary liver cancer （1）. The incidence is rising in the last decades due to many factors, especially hepatitis C, alcoholic liver disease and non-alcoholic steato...Hepatocellular carcinoma （HCC） is the most common primary liver cancer （1）. The incidence is rising in the last decades due to many factors, especially hepatitis C, alcoholic liver disease and non-alcoholic steatohepatitis. Moreover, the introduction of screening programs in patients with chronic liver disease has led to an increase in HCC diagnosis （1,2）. In the western world, 80% to 90% of HCC eases occur in patients with liver cirrhosis （3） while this proportion is lower in some regions in Asia and sub-Saharian Africa, where hepatitis B remains as an important etiologic factor for chronic liver disease （2,4）. In 1990, the annual world frequency of HCC was 437,000 cases/year （1）, and in 2012 the number reached 782,200 cases/year being responsible for 746,000 deaths （5）. Nowadays, HCC represents the 6th most frequent neoplastic disease in the world and the 3rd in mortality （5）.展开更多
Laparoscopic liver resection （LLR） for hepatocellular carcinoma （HCC） is increasing in this era of minimal invasive liver surgery. LLR for HCC is currently known to be a safer procedure than it was before because ...Laparoscopic liver resection （LLR） for hepatocellular carcinoma （HCC） is increasing in this era of minimal invasive liver surgery. LLR for HCC is currently known to be a safer procedure than it was before because of technical advances and improvement in postoperative patient management and remains the first-line treatment for HCC in compensated cirrhosis in many centers. We have the chance of analyzing the paper about the comparison between Middle Eastern and Western experience for LLR as treatment of HCC.展开更多
Hepatocellular carcinoma （HCC） is the most common primary liver tumor. It is the seventh world＇s most common cancer and rank second of all cancer deaths （I）. It incurs a global health burden, with 782,451 new cas...Hepatocellular carcinoma （HCC） is the most common primary liver tumor. It is the seventh world＇s most common cancer and rank second of all cancer deaths （I）. It incurs a global health burden, with 782,451 new cases diagnosed worldwide in the year 2012 and a morality of 745,517： a high incidence to morality ratio of 1.05. Majority of patients resides in the developing world and often presented late resulting in poor prognosis. Early detection is thus crucial for capturing early disease whereby curative resection can offer the best survival outcome （2）.展开更多
Endoscopic submucosal dissection was introduced in Japan for the mini-invasive treatment of early gastric cancer,as part of national screening program considering high prevalence of disease in these latitudes.This tec...Endoscopic submucosal dissection was introduced in Japan for the mini-invasive treatment of early gastric cancer,as part of national screening program considering high prevalence of disease in these latitudes.This technique allows en-bloc curative oncological excision and to obtain in a single step R0-resection,characterization,histological staging and potential cure of the tumor with a very high cost-benefit balance.Over the years,Western endoscopists have adopted endoscopic submucosal dissection,achieving good rates of efficacy,long-term improved outcomes and safety,with low risk of local recurrence comparable to those obtained in Asian institutes.However,according to some authors,the excellent outcomes from East country could not be representative of the Western experience.Despite epidemiological differences of early gastric cancer,scant volume data and limitations in training opportunities between Western and Eastern countries,European Society of Gastrointestinal Endoscopy have adopted Japanese guidelines and developed a European core curriculum for endoscopic submucosal dissection training.Endoscopists should be able to estimate the probability of performing a curative resection by considering the benefit/risk relationship case-by-case in order to implement a correct decision-making process.展开更多
文摘Hepatocellular carcinoma （HCC） is the most common primary liver cancer （1）. The incidence is rising in the last decades due to many factors, especially hepatitis C, alcoholic liver disease and non-alcoholic steatohepatitis. Moreover, the introduction of screening programs in patients with chronic liver disease has led to an increase in HCC diagnosis （1,2）. In the western world, 80% to 90% of HCC eases occur in patients with liver cirrhosis （3） while this proportion is lower in some regions in Asia and sub-Saharian Africa, where hepatitis B remains as an important etiologic factor for chronic liver disease （2,4）. In 1990, the annual world frequency of HCC was 437,000 cases/year （1）, and in 2012 the number reached 782,200 cases/year being responsible for 746,000 deaths （5）. Nowadays, HCC represents the 6th most frequent neoplastic disease in the world and the 3rd in mortality （5）.
文摘Laparoscopic liver resection （LLR） for hepatocellular carcinoma （HCC） is increasing in this era of minimal invasive liver surgery. LLR for HCC is currently known to be a safer procedure than it was before because of technical advances and improvement in postoperative patient management and remains the first-line treatment for HCC in compensated cirrhosis in many centers. We have the chance of analyzing the paper about the comparison between Middle Eastern and Western experience for LLR as treatment of HCC.
文摘Hepatocellular carcinoma （HCC） is the most common primary liver tumor. It is the seventh world＇s most common cancer and rank second of all cancer deaths （I）. It incurs a global health burden, with 782,451 new cases diagnosed worldwide in the year 2012 and a morality of 745,517： a high incidence to morality ratio of 1.05. Majority of patients resides in the developing world and often presented late resulting in poor prognosis. Early detection is thus crucial for capturing early disease whereby curative resection can offer the best survival outcome （2）.
文摘Endoscopic submucosal dissection was introduced in Japan for the mini-invasive treatment of early gastric cancer,as part of national screening program considering high prevalence of disease in these latitudes.This technique allows en-bloc curative oncological excision and to obtain in a single step R0-resection,characterization,histological staging and potential cure of the tumor with a very high cost-benefit balance.Over the years,Western endoscopists have adopted endoscopic submucosal dissection,achieving good rates of efficacy,long-term improved outcomes and safety,with low risk of local recurrence comparable to those obtained in Asian institutes.However,according to some authors,the excellent outcomes from East country could not be representative of the Western experience.Despite epidemiological differences of early gastric cancer,scant volume data and limitations in training opportunities between Western and Eastern countries,European Society of Gastrointestinal Endoscopy have adopted Japanese guidelines and developed a European core curriculum for endoscopic submucosal dissection training.Endoscopists should be able to estimate the probability of performing a curative resection by considering the benefit/risk relationship case-by-case in order to implement a correct decision-making process.
