Système gastro-intestinal et digestif

Abstrait

Role of Surveillance in Hepatocellular Carcinoma

Asghar Qasim

Hepatocellular carcinoma (HCC) is the most common primary liver tumour with rising incidence and has significant mortality of over 600,000 deaths annually. HCC is ranked as the third-leading cause of cancer-related deaths worldwide. An important feature is its unique geographic distribution due to the associated risk factors related to the tumour. Surveillance programmes are recommended in the specified targeted population and help in early diagnosis of HCC with timely therapeutic intervention.

Success of surveillance depends on multitude of factors including identification of the target population, proper use of surveillance tests through a structured programme and this in turn leading to proper management of HCC. The most important risk factor associated with HCC is hepatic cirrhosis. Important factors in the aetiology of cirrhosis include chronic infection from hepatitis B (HBV) and C (HCV) viruses and alcohol abuse. Another risk factor increasingly being recognised is non-alcoholic fatty liver disease. Radiological and serological investigations are employed in the screening and surveillance of HCC. Debatable issues in this regard include surveillance interval, efficacy of tests, outcomes of detected tumours and proper recall guidelines which are considered as important factors for success of surveillance programmes. Ultrasonography is considered as the most reliable test modality in surveillance programmes.