Malignant Liver Tumours: Basic Concepts and Clinical Management

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F. Berr, J. Bruix, J. Hauss, Ch. Wittekind, J. Wands
Springer Science & Business Media, Nov 30, 2002 - Medical - 224 pages
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Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC), both increasing in incidence, have become a major topic of basic and clinical research as well as clinical practice in hepatology. Experts in the field update the current concepts on the carcinogenesis of HCC and CC such as genetic alterations in the pathways of cell cylce and apoptosis regulation, the hypothesis of dedifferentiation of hepatocytes to the malignant phenotype vs that of activation of hepatic progenitor cells incapable of maturation (maturation arrest hypothesis). In spite of an increasing number of genetic alterations described in human HCC as well as cell regulatory pathways tested in experimental HCC models, the key hits causing progression of the cell cycle in imbalance with apoptosis, tissue invasive growth and metastatic potential of cell clones still remain elusive. Very powerful genomic and proteomic techniques are promising insights into the carcinogenesis of liver malignancies that will allow more efficient therapeutic strategies.

The current concepts on risk profiling, surveillance of risk groups and therapeutic strategies are evidence-based for HCC and less detailed for CC. Surveillance of risk groups improves detection of liver tumours in curable stages. Best strategies for curative treatment of HCC use neoadjuvant antitumour therapies before liver transplantation and a role is emerging for living donor-related liver transplantation. New palliative therapies for HCC are in the experimental stage with biological response modifiers, including angiogenesis inhibitors, and entering phase II clinical trials with the alpha-fetoprotein derived vaccines.

This book, the proceedings of Falk Workshop No. 127, held in Leipzig, Germany, January 24-25, 2002 (as Pre-meeting of the Annual Meeting of the German Association for the Study of the Liver) summarizes the expert knowledge on the carcinogenesis, surveillance of riskgroups, and clinical management of malignant liver tumours.

 

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Contents

Molecular pathogenesis of hepatocellular carcinoma
3
Altered signal transduction in human hepatocellular carcinoma
9
Interactions between cell proliferation and apoptosis in the development and progression of liver tumours
20
Invasive and metastatic growth of hepatocellular carcinoma
27
INDUCTION OF HEPATOCELLULAR CARCINOGENESIS
31
Hepatitis B virusinduced carcinogenesis
33
Hepatitis C virusinduced carcinogenesis
40
Role of progenitor cells in carcinogenesis?
44
EXPERIMENTAL APPROACHES TO NEW THERAPIES FOR HEPATOCELLULAR CARCINOMA
109
Immunotherapeutic strategies against hepatocellular carcinoma
111
Gene therapeutic approaches
124
Combination therapy of hepatocellular carcinoma with biological response modifiersq
145
Graft versus tumour suppression of hepatocellular carcinoma growth via induction of oral immuneregulation towards tumourassociated antigens
149
CHOLANGIOCARCINOMA
161
Aetiopathogenesis morphological features and molecular pathology of cholangiocarcinoma
163
Cholangiocarcinoma risk groups and diagnostic strategies
168

Dysplasiacarcinoma sequence?
57
CLINICAL MANAGEMENT OF HEPATOCELLULAR CARCINOMA
65
Risk groups and preventive strategies
67
Hepatocellular carcinoma pathological indicators of prognosis
75
Clinical staging and indicators of prognosis in patients with hepatocellular carcinoma
87
Nonsurgical interventional therapies
93
Nonsurgical palliative treatment for cholangiocarcinoma
177
SURGICAL TREATMENT AND PREVENTION OF RECURRENCE FOR HEPATOCELLULAR CARCINOMA
189
Prevention of recurrence for hepatocellular carcinoma after curative surgery
191
Surgical treatment for hepatocellular carcinoma the role of living donor liver transplantation
201
Index
205
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