Non-Resective Ahlative Therapy for Hepatocehular Carcinoma

Abstract

Hepatocellular carcinoma (HCC) is defined as a malignant tumor derived from hepatocyte. BCC is the most common fonn of primary liver malignancy. It is a highly malignant tumor with extremely poor prognosis. HCC is the third most frequent cause of death from cancer in the world (Grieco et al., 2005). HCC is one of the most common malignancies worldwide, with an annual occurrence of at least one million new cases (LAU et al., 2003). In the Western world, HCC is closely associated with hepatic cirrhosis, which is present in 70-80% of all cases (Poynard et al., 1997; Trevisani et al., 2001). HCC accounts for 7.4% of all cancers in males and 3.2% of all cancers in females (Sherlock and Dooley, 2002). Its mortality is secondary to lung cancer in urban and gastric carcinoma in China (Tang, 2001}. The incidence of HCC varies widely according to geographic location. Sub­ Saharan Africa and Eastern Asia are two high-incidence regions (Okuda et al., 1999). The incidence ranges from <10 cases per 100000 persons in North America and Western Europe to 50-150 cases per 100000 persons in parts of Africa and Asia, where HCC is responsible for a large number of cancer deaths. This may be due to a combination of a real increase in incidence, better diagnostic tools, and increasing awareness or enhanced referral pattern. The incidence of HCC is age related, but the age distribution differs in different local regions of the world. The pattern suggests & that with urbanization the median age of onset is shifted to older age groups. However, in developed countries the incidence of HCC only really starts to increase over about age 45 and continues to increase until the 70s. These differences may reflect ·a difference in the age of exposure to hepatitis viruses, exposure occurring at younger ages· in high-incidence countries. Men are at higher risk for HCC than