RECENT TRENDS IN MANAGEMENT OF HEPATOCEllULAR CARCINOMA CHCCJ

Abstract

The clinical picture of HCC is very variable, the patient may be completely asymptomatic with no physical signs other than those of cirrhosis, the tumor may have been diagnosed incidentally. Alternatively, the presentation may be so florid and great that the picture resembles a liver abscess. (Di Bisceglie, et al., 1998). Because HCC is slow-growing, with a doubling time of 4 to 5 months for small HCCs, ultra sound examination every 6 months and serum AFP and liver function tests are estimated every 3 months. There is little diagnostic doubt in a patient with a liver mass consistent with HCC and a serum AFP of more than 500ng/ml. This combination is diagnostic, and treatment can be instituted without tissue diagnosis. (Collier & Sherman, 1998). The therapeutic modalities in patients with (HCC) depend on the number, size and location of the lesions as well as the stage of the underlying liver disease and the physical condition of the patient. In patients with small and solitary lesions, resection, liver transplantation and in some cases percutaneous ethanol injection (PET) can be curative. ln more advanced stages of the disease with larger or multiple lesions, PEI and/or trans-arterial chemotherapy. With or without embolization (TACE or TAC) can slow the progression of the disease. In disseminated disease, a radio therapeutic approach can be taken in selected cases. The therapeutic strategy in patients with HCC should be individualized, frequently