Liver Malignancies

This book explores in detail the primary liver cancers of hepatocellular carcinoma and cholangiocarcinoma examining the pathogenesis of disease along with diagnosis and current management options together with exploration of future treatment strategies and areas of controversy. Furthermore, the book highlights management of the common secondary malignancies and touches on benign liver tumours and how to best manage these. Written in a clear and didactic style, this volume includes summaries of the key learning points and questions so that the reader can gauge their knowledge and understanding. This book is aimed to broaden the knowledge base of primary care physicians, general physicians along with specialists in hepatology, oncology and hepato-biliary surgery

One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.

This book aims to illuminate the causes, incidence, and treatments of Hepatocellular Carcinoma(HCC) or liver cancer in the politically important and societally diverse region of the Middle East. Taking a flexible and inclusive view, it examines the influences of geography, crops and diet, ethnicity, and local behavior on both diagnosis and outcomes of this disease. Understanding the different causes of liver cancer enables effective strategies for both prevention and early diagnosis while knowledge of the different treatment modalities, their uses and limitations, availability and costs, works to inform rational treatment provision and selection. Divided into four sections, this book considers the causes and clinical syndromes associated with HCC, provides a detailed overview of clinical HCC and treatment modalities, describes country-specific clinical HCC experience and practice, and considers future needs and the potential for HCC collaborations across the region. Liver Cancer in the Middle East is a useful resource for clinicians seeking insight into the second highest cause of death from cancer worldwide, governments planning social and medical services for their peoples, as well as for international aid agencies prioritizing donations.

This comprehensive and critical review of current and established treatment modalities for malignant liver tumors is designed to help you sort through the proliferation of competitive approaches and choose the best treatment options for your patient. Dr. Clavien and his contributors consider all the options – radiological, surgical, pharmaceutical, and emerging/novel therapies – and help you find the best single or combined therapy. Building on the success of the previous edition, this extremely thorough revision: features a new section on Guidelines for Liver Tumors, where you will find specific strategies for treating common liver malignancies; the guidelines were prepared by the Associate Editors and take into account national and international society guidelines reflects actual practice by taking a multidisciplinary approach, with contributions from international experts who have extensive experience with this patient population achieves comprehensive and balanced coverage by having each chapter reviewed by the Editor, Deputy Editor, two Associate Editors, and at least one external reviewer includes 16 new chapters that cover liver anatomy, histologic changes in the liver, epidemiology and natural history of HCC, CCC and colorectal liver metastases, strategies of liver resection, and economic aspects as well as novel therapies facilitates the kind of daily interaction among hepatologists, hepatic surgeons, medical oncologists, radiotherapists, and interventional radiologists that is essential when treating patients with complex liver malignancies In 44 chapters organized into six major sections, the book covers the full range of liver tumors. The perfect blend of evidence and experience, Malignant Liver Tumors: Current and Emerging Therapies, 3rd Edition, illuminates the path to better patient care.

The global epidemic of hepatitis B and C is a serious public health problem. Hepatitis B and C are the major causes of chronic liver disease and liver cancer in the world. In the next 10 years, 150,000 people in the United States will die from liver disease or liver cancer associated with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections. Today, between 800,000 and 1.4 million people in the United States have chronic hepatitis B and between 2.7 and 3.9 million have chronic hepatitis C. People most at risk for hepatitis B and C often are the least likely to have access to medical services. Reducing the rates of illness and death associated with these diseases will require greater awareness and knowledge among health care workers, improved identification of at-risk people, and improved access to medical care. Hepatitis B is a vaccine-preventable disease. Although federal public health officials recommend that all newborns, children, and at-risk adults receive the vaccine, about 46,000 new acute cases of the HBV infection emerge each year, including 1,000 in infants who acquire the infection during birth from their HBV-positive mothers. Unfortunately, there is no vaccine for hepatitis C, which is transmitted by direct exposure to infectious blood. Hepatitis and Liver Cancer identifies missed opportunities related to the prevention and control of HBV and HCV infections. The book presents ways to reduce the numbers of new HBV and HCV infections and the morbidity and mortality related to chronic viral hepatitis. It identifies priorities for research, policy, and action geared toward federal, state, and local public health officials, stakeholder, and advocacy groups and professional organizations.

The incidence of primary and metastatic liver tumors is rising and the therapeutic armamentarium for these tumors is expanding at a rapid pace. Surgery remains the primary treatment modality for these tumors. With improvements in our perioperative management and operative techniques a larger proportion of patients are able to undergo potentially curative liver surgery. In addition, indications and criteria for liver transplantation for both primary and metastatic liver tumors are constantly expanding. Unfortunately, many patients are not amendable to surgical resection or liver transplantation and therefore alternative liver-directed therapies are routinely being implemented as part of complex multidisciplinary treatment models. However, these models are continually evolving as these regional therapeutic options continue to expand. New embolization agents and techniques, as well as, improvements in radiation delivery, are all evolving in the background of improvement in systemic and targeted therapy options for these tumors. This book provides a comprehensive, state-of-the art review of the current state of liver-directed therapy for malignant liver tumors. The book will serve as a valuable resource for not only surgeons and clinicians but for researchers with an interest in malignant liver tumors. The book focuses on the therapeutic approach to primary and metastatic tumors providing an up-to-date review on surgical liver anatomy and new imaging techniques as well as patient selection and technical consideration for resection and transplantation. In addition, the book provides new insight into novel and evolving therapies in the areas of transarterial therapy such as: (i) bland embolization, (ii) chemoembolization, and (iii) radioembolization; as well as new radiation techniques including SBRT and proton therapy. Furthermore, the expanding role of hepatic artery infusion therapy in primary malignant tumors is highlighted. Finally, integration of all these regional therapy options with upcoming and evolving systemic and targeted therapy regimens are integrated and discussed. This book will serve as a very useful resource for clinicians and researchers managing and treating patients with these challenging malignancies. It provides a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts. All chapters are written by experts in their fields and include the most up to date scientific and clinical information.