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Hepatocelulární karcinom – možnosti radikální léčby
Title in English | Hepatocellular carcinoma - possibilities of the radical treatment |
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Authors | |
Year of publication | 2011 |
Type | Article in Periodical |
Magazine / Source | Farmakoterapie |
MU Faculty or unit | |
Citation | |
Field | Surgery incl. transplantology |
Keywords | hepatocellular carcinoma; surgical treatment; radical; liver transplantation; resection |
Description | HCC represents the sixth most frequent malignancy worldvide and is the third most frequent cause of tumour related death. Material and methods: A survey over causes, diagnostics and treatment methods has been conducted. Results: The development of HCC in non-cirrhotic liver is very rare. All patients with liver cirrhosis that is caused mainly by HBV and HCV infection should be screened with a plain liver US every 6 months. There is no use of AFP level in screening but in staging. HCC is the only tumour the diagnosis of which can be made upon dynamic imaging methods - ot comprises typical appearance of HCC at two different methods (CEUS, dynamic contrast MRI, dynamic CT) in tumour 1-2 cm in diameter or at the only one dynamic method when the diameter is above 2cm. Laesions smaller than 1cm are to be checked with US at 3 months intervals. Uncertain cases ought to be biopsied until positive result. The BCLC screening system seems to be a suitable staging tool. Surgery and liver transplantation do not seem to be concurent but rather complementary. TACE or RFA may help in nonresectable cases. Sorafenib has become a standard treatment for advanced HCC. |