Hepatocellular Carcinoma: Targeted Therapy and Multidisciplinary P9

4 Screening of HCC 65 rate. If a screening is to be cost-effective at all, a feasible treatment should exist that can favorably affect the prognosis of patients. Conclusions High-risk populations for HCC have been clearly identified in many epidemio-logical studies and statistical analyses. HCC is a suitable disease for surveillance programs because it is relatively common, at least in patients with liver disease. The early detection and diagnosis of HCC allow patients to be treated curatively. Nonetheless, whether routine screening and surveillance for HCC actually improve outcome would be best determined by prospective randomized controlled trials. References 1. Parkin DM, Bray F, Ferlay J, Pisani P (2001) Estimating the world cancer burden: Globocan 2000. Int J Cancer 94:153–156 2. Bosch FX, Ribes J, Diaz M, Cleries R (2004) Primary liver cancer: worldwide incidence and trends. Gastroenterology 127:S5–S16 3. 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Sarasin FP, Giostra E, Hadengue A (1996) Cost-effectiveness of screening for detection of small hepatocellular carcinoma in western patients with Child-Pugh class A cirrhosis. Am J Med 101:422–434 65. Everson GT (2000) Increasing incidence and pretransplantation screening of hepatocellular carcinoma. Liver Transpl 6:S2–10 Chapter 5 Staging of Hepatocellular Carcinoma Hari Nathan and Timothy M. Pawlik Keywords HCC staging · Okuda staging system · Cancer of the Liver Italian Program (CLIP) score · Barcelona Clinic Liver Cancer (BCLC) staging system · Liver Cancer Study Group of Japan (LCSGJ) staging system · Japanese Integrated Staging (JIS) score · Chinese University Prognostic Index (CUPI) · American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) staging system Introduction Staging systems aim to stratify patients into groups with similar prognoses. As such, these staging systems may serve to guide choice of therapy, aid in patient counseling, allow comparisons of the end results of therapy, and facilitate patient selection and randomization for research protocols. Staging systems for hepatocel-lular carcinoma (HCC) are broadly divided into clinical and pathological staging systems. The clinical staging systems can be particularly useful in guiding choice of therapy and include the Okuda staging system [1], Cancer of the Liver Italian Program (CLIP) score [2], and Barcelona Clinic Liver Cancer (BCLC) staging sys-tem [3]. The pathologic staging systems are useful after resection or transplantation and include the Liver Cancer Study Group of Japan (LCSGJ) staging system [4], Japanese Integrated Staging (JIS) score [5], Chinese University Prognostic Index (CUPI) [6], and American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) staging system [7, 8]. This chapter reviews these staging systems and highlights their relative strengths and weaknesses. T.M. Pawlik ( ) Division of Surgical Oncology, Department of Surgery, The Johns Hopkins School of Medicine, Baltimore, MD, USA K.M. McMasters, J.-N. Vauthey (eds.), Hepatocellular Carcinoma, 69 DOI 10.1007/978-1-60327-522-4_5, C Springer Science+Business Media, LLC 2011 ... - tailieumienphi.vn