Novel advancements in the management of hepatocellular carcinoma in 2008

Representation of the switch in the presentation of HCC in developed countries, as a result of implementation of surveillance among cirrhotic patients. Estimates of applicability of potentially curative therapies have been divided in three periods: until 1990: 5–10% of cases; 1990–2010: 30–40% of cases; 2010–2020: 40–60% of cases.

Accuracy of the molecular diagnosis of HCC, by using a 3-gene set with Glypican-3, LYVE1 and survivin. Gene expression profiles of the three genes included in the best gene signatures in all the stages of the hepatocarcinogenic process. Results are expressed as fold-change. Boxes reflect median gene expression (25–75 percentile). Legend: controls (C, n=10), cirrhosis (Ci, n=10), dysplastic nodules (D, n=17), early HCC ([E, n=20), advanced HCC [n=20].

Immunostaining for GPC3, counterstained with hematoxylin: (A) low grade dysplastic nodule, negative for GPC3 (200×); (B) positive GPC3 staining in a 0.8cm HCC and negative staining in the cirrhotic nodule (100×); (C) higher magnification showing diffuse cytoplasmic staining for GPC3 in tumor cells (400×); (D) advanced HCC reacted strongly for GPC3 (100×).

Strategies to prevent HCC recurrence after resection or local abaltion, considering true recurrences and de novo tumors.