Is one scoring system in patient assessment more useful than another?
Is microbubble ultrasound an advance in surveillance screening?
Clinical Dilemmas in Primary Liver Cancer considers these and other questions in a highly practical, user–friendly format.
Edited by Roger Williams and Simon Taylor–Robinson, two of the UK′s top hepatologists and leading figures on liver cancer, this concise guide provides evidence–based expert guidance on subjects ranging from epidemiological risk factors and screening and surveillance strategies to diagnosis and treatment.
Contributing authors, experts in particular areas in liver cancer treatment, know your daily clinical challenges because they share them. The six major sections of the book cover:
- Learning from a worldwide perspective
- Influence of tumour characteristics
- Complexities of patient assessment and scoring systems
- Choice of radiological diagnostic technique
- Can treatment be tailored to the patient?
- What does the future hold?
Recent advances allowing early diagnosis and use of locoregional and systemic therapy, surgery, transplantation, and combination therapy may help to reverse the established pattern of patients presenting with advanced disease, and the authors carefully review these important developments.
Clinical Dilemmas in Primary Liver Cancer is essential reading for all those involved in the care of patients with liver cancer, including established and trainee hepatologists and gastroenterologists, transplant surgeons, pathologists, and specialist hepatology nurses.
List of Contributors, vii
Part 1: Learning from a Worldwide Perspective
1 Are patterns and prevalence changing?, 3
Hashem B. El–Serag
2 Why is the tumour different in Africa?, 11
Nimzing G. Ladep
3 Control by vaccination: Asian and Taiwan experience, 18
4 The view from the United Kingdom, 24
Shahid A. Khan, Mireille B. Toledano, Abigail Zabron, Mehtan Ahmed, and Simon D. Taylor–Robinson
5 The view from the United States, 29
Hitoshi Maruyama and Arun J. Sanyal
6 New challenges of the NAFLD and HIV epidemics, 35
Quentin M. Anstee and Janice Main
Part 2: Influence of Tumour Characteristics
7 Controversies in pathology, 45
8 Not to forget the unusual tumour, 53
Bernard C. Portmann
9 What can be learned from molecular diagnostic techniques and genetic signatures?, 60
Tariq Moatter and Saeed Hamid
Part 3: Complexities of Patient Assessment and Scoring Systems
10 Looking after the liver as well as the tumour, 67
11 Comparative performances of staging systems for hepatocellular cancer: early HCC considerations, 75
Peter D. Peng and Timothy M. Pawlik
12 Rival scoring systems: do they offer more?, 81
Angelo Sangiovanni and Massimo Colombo
13 Is it possible to detect early lesions effectively?, 91
Ryota Masuzaki and Masao Omata
14 What is the value of country–based surveillance programmes?, 97
Part 4: Choice of Radiological Diagnostic Technique
15 Computed tomography or magnetic resonance imaging for the diagnosis of hepatocellular carcinoma, 107
16 Is Microbubble ultrasound useful?, 114
17 Value of PET scanning, 118
Tara D. Barwick, Imene Zerizer, and Adil Al–Nahhas
Part 5: Can Treatment be Tailored to the Patient?
18 Who could benefit from chemoembolisation?, 127
Gisele N′Kontchou, Olivier Seror, and Michel Beaugrand
19 Are drug–eluting beads worth using?, 136
Christopher N. Hacking and Pradesh Kumar
20 What is the future of image–guided radiofrequency ablation for hepatocellular carcinoma?, 142
21 Alternative ablation techniques for hepatocellular carcinoma, 149
22 Justification for sorafenib and chemotherapy, 154
Philip J. Johnson
23 When to consider surgery?, 160
Emmanuel Melloul, Mickael Lesurtel, and Pierre–Alain Clavien
24 Transplant considerations, 168
Part 6: What Does the Future Hold?
25 Dipstick markers for diagnosis: feasible or not?, 179
Mohamed I.F. Shariff and Simon D. Taylor–Robinson
26 Targeted gene therapy for hepatocellular carcinoma: a reality?, 184
Christopher Binny, Marco Della Peruta, and Amit C. Nathwani
27 Is immune modulation a possibility?, 191
Tim F. Greten and Firouzeh Korangy
28 Systemic therapy for hepatocellular carcinoma: future directions, 199
Daniel H. Palmer, Matthew E. Cramp
Colour plate section can be found facing page 86