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Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 7, 2017; 23(29): 5282-5294
Published online Aug 7, 2017. doi: 10.3748/wjg.v23.i29.5282
From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world
Dimitrios Dimitroulis, Christos Damaskos, Serena Valsami, Spyridon Davakis, Nikolaos Garmpis, Eleftherios Spartalis, Antonios Athanasiou, Demetrios Moris, Stratigoula Sakellariou, Stylianos Kykalos, Gerasimos Tsourouflis, Anna Garmpi, Ioanna Delladetsima, Konstantinos Kontzoglou, Gregory Kouraklis
Dimitrios Dimitroulis, Christos Damaskos, Nikolaos Garmpis, Stylianos Kykalos, Gerasimos Tsourouflis, Konstantinos Kontzoglou, Gregory Kouraklis, Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
Serena Valsami, Blood Transfusion Department, Aretaieion Hospital, Medical School, National and Kapodistrian Athens University, 15772 Athens, Greece
Spyridon Davakis, First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
Eleftherios Spartalis, N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
Antonios Athanasiou, Department of Surgery, Mercy University Hospital, Grenville Pl, T12 WE28 Cork, Ireland
Demetrios Moris, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
Stratigoula Sakellariou, Ioanna Delladetsima, First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
Anna Garmpi, Internal Medicine Department, Laiko General Hospital, University of Athens Medical School, 15772 Athens, Greece
Author contributions: Dimitroulis D and Damaskos C contributed equally to this work; Dimitroulis D, Damaskos C, Valsami S and Davakis S designed the research and wrote the paper; Dimitroulis D, Damaskos C, Garmpis N, Kykalos S, Delladetsima I, Kontzoglou K and Kouraklis G reviewed the paper; Spartalis E, Athanasiou A, Moris D, Sakellariou S, Tsourouflis G and Garmpi A collected the data.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dimitrios Dimitroulis, MD, MSc, PhD, Assistant Professor of Surgery, Second Department of Propedeutic Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Medical School, 17 Agiou Thoma Street, 11527 Athens, Greece. dimitroulisdimitrios@yahoo.com
Telephone: +30-697-2420547 Fax: +30-213-2061772
Received: March 15, 2017
Peer-review started: March 17, 2017
First decision: April 7, 2017
Revised: May 3, 2017
Accepted: June 9, 2017
Article in press: June 12, 2017
Published online: August 7, 2017
Processing time: 144 Days and 13.3 Hours
Abstract

Hepatocellular carcinoma (HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer Staging System remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma.

Keywords: Hepatocellular; Cancer; Epidemiology; Treatment; Diagnosis; Staging; Transplantation

Core tip: Hepatocellular carcinoma (HCC) is the most frequent primary liver malignancy. It consists an epidemic problem for both developed and developing world. HCC remains a challenge to early diagnose, and treat effectively. This review article focuses on the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma. This review will be highly educational as it describes all the current data for HCC.