Hepatocellular carcinoma

Risk factor- HBV, HCV, nitrosamine, aflatoxin, senecio alkaloid, alcohol, metabolic syndrome, DM, iron overload, obesity, Alpha-1 antitrypsin deficiency, AIP, gallstone, cholecystectomy, red meat

Protective factor- Statin, aspirin, NSAID, white meat

CT- Arterial phase(early enhance, hyperdense), Venous phase(early washout, hypodense)

Systemic effect and paraneoplastic syndrome- Painful gynecomastia, hypercalcemia, hypoglycemia, hyperlipidemia, hyperthyroidism, pseudo-porphyria

Presentation- Abdominal pain, weight loss, early satiety, palpable mass, tumor rupture, 

Paraneoplastic syndrome- Hypoglycemia, erythrocytosis, hypercalcemia, diarrhea

Metastasis(>5cm, large vessel invasion)- Lung, bone, adrenal gland

Okuda staging system

Tumor mass>=50% of liver<50% of liver
Bilirubin>=3< 3

Stage I-0, Stage II-1~2, Stage III-3~4

CLIP score

Tumor morphologysingle & <50%multiple & <50%multiple & >50%
Portal vein thrombosisnoyes

BCLC staging

StagePSTTumor stageOkuda stageChild-PughTreatment
A0single<5cm or 3 <3cmIA-BSingle- Resection > transplantation >ablationMultiple- Transplantation >ablation
B0single>5cm or multiple >3cmI~IIA-BChemoembolization(TACE)(Doxorubicin/ Adriamycin, Lipidol)
C1~2vessel invasion or extrahepatic invasionI~IIA-BSystemic therapy(Sorafenib)
RFAMore complication than PEI
PEIInjection of ethanol and acetic acid, less pain
TAELipidol and Gelform
TACELipidol and Gelform + Adriamycin

Published by Steve Johnson

I am a doctor who like to organise knowledges and share ideas with others. As a doctor, a lot of knowledges influx everyday and need some patient to organise and absorb. Here was my notes to share with you and hope to save your time to know it.

Leave a comment

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: