Background Flashcards
What liver Dz is associated with hepatocellular carcinoma (HCC)?
Most HCCs develop in pts with cirrhosis from liver parenchymal Dz. Exposures and Dz that cause chronic hepatitis and cirrhosis are almost uniformly associated with HCC.
HCC is most common in what 2 regions in the world?
Most common regions for HCC:
- Asia (East > Southeast)
- Africa (middle > East > West)
Name 2 viruses associated with HCC.
Most important viral causes of HCC:
- Hepatitis B virus (HBV) (carrier state without associated cirrhosis is also a cause)
- Hepatitis C virus (HCV)
Name the 2 most important environmental exposures associated with HCC.
Environmental exposures associated with HCC:
- Heavy ethanol consumption, which leads to cirrhosis
- Aflatoxin B, a mycotoxin that contaminates corn, soybeans, and peanuts, generally in sub-Saharan Africa and East and Southeast Asia
Name 3 hereditary conditions associated with HCC.
Relatively common hereditary conditions associated with HCC:
- Hemochromatosis
- α1-antitrypsin deficiency
- Wilson Dz
Is there a sex predilection for HCC?
Yes. Males are 3 times more likely to develop HCC.
Worldwide, where does HCC rank as a cause of cancer death?
Worldwide, HCC is the 4th leading cause of cancer death (3rd for men), but rates vary dramatically by region.
HCC incidence peaks in what decade of life?
HCC incidence peaks in the 6th decade of life.
What is the most common clinical presentation of HCC?
The most common clinical presentation of HCC is rising AFP in the setting of worsening pre-existing liver Dz.
Who should be screened for HCC and how?
Pts with cirrhosis, hepatitis B carrier state, or nonalcoholic steatohepatitis should be screened for HCC. Screen with AFP and liver US q6–12 mos.
Do most pts with HCC present with localized or metastatic Dz?
90% of HCC pts present with localized Dz.
In HCC, what are the most common sites of mets spread?
HCC most commonly metastasizes to intra-abdominal LNs and lungs. Less common sites of mets include bone, brain, and adrenal glands.
