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Hepatocellular Carcinoma: State of the Art - missing is &
Post HCV Cure Surveillance in Patients with Cirrhosis !
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AASLD nov 4-8 2022
![1121221](../images/112422/112122-5/1121221.gif)
![1121222](../images/112422/112122-5/1121222.gif)
We need NOW to be aggressive about prevention, early detection & treatment.
we see a rising mortality rate in men & women, one of the few cancers in which we see this. If these trends continue HCC is projected to be 3rd leading cause of death by 2035.
![1121223](../images/112422/112122-5/1121223.gif)
the AT RISK POPULATION we need to target are those with cirrhosis OR at risk for cirrhosis.
BUT there is some risk to get HCC without having cirrhosis in HBV & NASH. But only in HBV do we recommend HCC screening without having first cirrhosis.
Cirrhosis creates an identifiable at-risk population.
![1121224](../images/112422/112122-5/1121224.gif)
EARLY DETECTION IS KEY TO SURVIVAL
![1121225](../images/112422/112122-5/1121225.gif)
IMPORTANCE OF SCREENING
#! patients with CIRRHOSIS cured by DAAs who are SILL at risk for HCC & MUST continue regular screening BUT do NOT - we see years later many of these patients coming up with large HCCs no longer treatable. ULTRASOUND + AFP - this is new recommendation in GUidance for this group for continued surveillance.
Many prefer using MRI instead of ultrasound, they think its BETTER.
![1121226](../images/112422/112122-5/1121226.gif)
25% of patients with cirrhosis are screened
![1121227](../images/112422/112122-5/1121227.gif)
![1121228](../images/112422/112122-5/1121228.gif)
![1121229](../images/112422/112122-5/1121229.gif)
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