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Hepatocellular Carcinoma - From Screening to Treatment: Current Practice, Pearls, and Puzzles
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- 1 Intro
- 2 Objectives
- 3 HCC is a global health problem.
- 4 HCC is a leading cause of liver-related and cancer-related mortality.
- 5 Liver cancer surveillance saves lives.
- 6 At risk populations are changing with the changing natural history of liver disease.
- 7 How do we identify opportunities for directed education and outreach?
- 8 Ultrasound lacks sensitivity for early stage detection of HCC.
- 9 Could we move the needle on early detection?
- 10 Cirrhosis is highly prevalent and MRI is readily available at the VA.
- 11 Will earlier detection with aMRI actually result in a cancer-related mortality benefit?
- 12 PREventing liver cancer Mortality through Imaging with Ultrasound vs. MRI (PREMIUM)
- 13 PREMIUM is a nine-year study.
- 14 Biomarkers for early detection vary in performance and readiness
- 15 Liquid biopsy is encouraging, but requires cross validation and better precision
- 16 Teasing out oncogenic pathways from hepatic injury and repair is complex (and not linear).
- 17 HCC is clinically complicated, because it is unique among cancers.
- 18 Treatment of HCC has followed a linear pathway from early to advanced disease.
- 19 Multidisciplinary care is essential.
- 20 There are many options for locoregional therapy in early and intermediate stage disease
- 21 The current paradigm is based on clinical characteristics
- 22 We need to collectively strive for a personalized approach.
- 23 Key take aways
