HEPATOCELLULAR CARCINOMA (HCC)
- Primary Hepatic Carcinoma: a comprehensive review - http://www.emedicine.com/med/topic2664.htm
- Hepatocellular Carcinoma in Children - http://www.emedicine.com/ped/topic983.htm
- Hepatocellular Carcinoma: radiological perspective - http://www.emedicine.com/radio/topic332.htm
- Chemoembolization for HCC - http://www.emedicine.com/radio/topic800.htm
- Cirrhosis of Liver: a comprehensive review - http://www.emedicine.com/med/topic3183.htm
- Cirrhosis of Liver: radiological perspective - http://www.emedicine.com/radio/topic175.htm
- American Society of Clinical Oncology (ASCO) Patient Guide: Preventing and Treating Nausea and Vomiting Caused by Cancer Treatment - http://www.plwc.org/plwc/MainConstructor/1,1744,_12-001129-00_14-00Patient%20Guides-00_17-001029-00_18-008042-00_19-0024556-00_20-001-00_21-008,00.asp
Measures:
Lab Studies:
- American Association of Clinical Chemistry: Liver Function Tests - http://www.labtestsonline.org/understanding/analytes/liver_panel/glance.html
- American Association of Clinical Chemistry: Prothrombin Time (PT) & International Normalized Ratio (INR) - http://www.labtestsonline.org/understanding/analytes/pt/glance.html
- American Association of Clinical Chemistry: Activated Partial Thromboplastin Time (aPTT) - http://www.labtestsonline.org/understanding/analytes/aptt/glance.html
- American Association of Clinical Chemistry: Albumin - http://www.labtestsonline.org/understanding/analytes/albumin/glance.html
Tumor Markers:
- National Academy of Clinical Biochemistry (NACB) Guidelines for the Use of Tumor Markers in Primary Liver Cancer - http://www.nacb.org/lmpg/tumor/chp3d_liver.pdf
- American Association of Clinical Chemistry: Alpha-fetoprotein Tumour Marker - http://www.labtestsonline.org/understanding/analytes/afp_tumor/glance.html
Imaging Studies:
- American College of Radiology (ACR) Appropriateness Criteria for different radiological investigations in a suspected case of hepatic carcinoma - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=11771&CID=1207&VID=2&DOC=File.PDF
- American College of Radiology (ACR) Appropriateness Criteria for different radiological investigations in order to characterize a hepatic lesion - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=11767&CID=1207&VID=2&DOC=File.PDF
- ACR Practice Guideline for the Performance of Computed Tomography (CT) of the Abdomen and Computed Tomography (CT) of the Pelvis - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=12200&CID=547&VID=2&DOC=File.PDF
- ACR Practice Guideline for the Performance and Interpretation of CT Angiography (CTA) - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=22486&CID=546&VID=2&DOC=File.PDF
- ACR Practice Guideline for the Performance of Magnetic Resonance Imaging (MRI) of the Liver - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=22487&CID=547&VID=2&DOC=File.PDF
- ACR Practice Guideline for the Performance of Pediatric and Adult Body Magnetic Resonance Angiography (MRA) - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=22485&CID=546&VID=2&DOC=File.PDF
- ACR Practice Guideline for Performing and Interpreting Diagnostic Ultrasound Examinations - http://www.acr.org/s_acr/bin.asp?CID=539&DID=12267&DOC=FILE.PDF
- ACR Practice Guideline for the Performance of FDG-PET Scintigraphy in Oncology - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=12222&CID=1074&VID=2&DOC=File.PDF
- ACR Technical Standard for Diagnostic Procedures Using Radiopharmaceuticals - http://www.acr.org/s_acr/bin.asp?CID=1074&DID=12278&DOC=FILE.PDF
- Medline Plus: Chest X-ray: The aim is to rule out pulmonary metastasis - http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm
- Practice Guideline for the Performance of Paediatric and Adult Chest Radiography - http://www.acr.org/s_acr/bin.asp? TrackID=&SID=1&DID=12194&CID=545&VID=2&DOC=File.PDF
Radiation Therapy:
- ACR Practice Guideline for the Performance of Stereotactic Body Radiation Therapy - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=17780&CID=1075&VID=2&DOC=File.PDF
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ACR Practice Guideline for Radiation Oncology - http://www.acr.org/s_acr/bin.asp?CID=1075&DID=12276&DOC=FILE.PDF
Liver Biopsy:
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ACR Practice Guideline for the Performance of Image-Guided Percutaneous Needle Biopsy (PNB) in Adults - http://www.acr.org/s_acr/bin.asp?TrackID=&SID=1&DID=12272&CID=1076&VID=2&DOC=File.PDF
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Medline Plus: Liver biopsy - http://www.nlm.nih.gov/medlineplus/ency/article/003895.htm
Informed Consent for Image-guided Procedures:
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ACR Practice Guideline on Informed Consent for Image-guided Procedures - http://www.acr.org/s_acr/bin.asp?CID=1076&DID=12236&DOC=FILE.PDF
Testing for the underlying cause of HCC:
Tests for Alcoholism:
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American Association of Clinical Chemistry: Testing for Alcoholism - http://www.labtestsonline.org/understanding/conditions/alcoholism-2.html
Tests for viral hepatitis:
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Test for HBsAg - American Association for Clinical Chemistry- http://www.labtestsonline.org/understanding/analytes/hepatitis_b/test.html -
US National Centre for Infectious Diseases: Interpretation of the Hepatitis B Panel - http://www.cdc.gov/ncidod/diseases/hepatitis/b/Bserology.htm -
Special Considerations in Interpreting Liver Function Tests: A number of pitfalls can be encountered in the interpretation of common blood liver function tests. These tests can be normal in patients with chronic hepatitis or cirrhosis. The normal range for aminotransferase levels is slightly higher in males, nonwhites and obese persons. Severe alcoholic hepatitis is sometimes confused with cholecystitis or cholangitis. Conversely, patients who present soon after passing common bile duct stones can be misdiagnosed with acute hepatitis because aminotransferase levels often rise immediately, but alkaline phosphatase and gamma-glutamyltransferase levels do not become elevated for several days. Asymptomatic patients with isolated, mild elevation of either the unconjugated bilirubin or the gamma-glutamyltransferase value usually do not have liver disease and generally do not require extensive evaluation. Overall hepatic function can be assessed by applying the values for albumin, bilirubin and prothrombin time in the modified Child-Turcotte grading system - http://www.aafp.org/afp/990415ap/2223.html - Guidelines for Laboratory Testing and Result Reporting of Antibody to Hepatitis C Virus: Testing for the presence of antibody to hepatitis C virus (anti-HCV) is recommended for initially identifying persons with hepatitis C virus (HCV) infection. Substantial variation in reflex supplemental testing practices exists among laboratories, and an anti-HCV–positive laboratory report does not uniformly represent a confirmed positive result. These guidelines expand recommendations for anti-HCV testing to include an option for reflex supplemental testing based on screening-test– positive signal-to-cut–off (s/co) ratios. Use of s/co ratios minimizes the amount of supplemental testing that needs to be performed while improving the reliability of reported test results. Adoption of these guidelines by all public and private laboratories that perform in vitro diagnostic anti-HCV testing will improve the accuracy and utility of reported anti-HCV test results for counseling and medical evaluation of patients by health-care professionals and for surveillance by public health departments - http://www.cdc.gov/mmwr/PDF/rr/rr5203.pdf
Tests for Hemochromatosis:
- American Association for Clinical Chemistry: Total iron-binding capacity (TIBC) & Transferrin - http://www.labtestsonline.org/understanding/analytes/tibc/glance.html
- American Association for Clinical Chemistry: Ferritin - http://www.labtestsonline.org/understanding/analytes/ferritin/glance.html
- American Association for Clinical Chemistry: Serum Iron - http://www.labtestsonline.org/understanding/analytes/serum_iron/glance.html
- American Association for Clinical Chemistry: Haemoglobin - http://www.labtestsonline.org/understanding/analytes/hemoglobin/glance.html
- American Association for Clinical Chemistry: Hematocrit; also called Packed cell volume (PCV) - http://www.labtestsonline.org/understanding/analytes/hematocrit/glance.html
- DNA Testing for Hereditary Hemochromatosis - http://www.mostgene.org/gd/gdvol14c.htm
Statistics:
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US National Cancer Institute: Hepatic Carcinoma Stats - http://seer.cancer.gov/statfacts/html/livibd.html
Screening For HCC:
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US National Cancer Institute: Screening For HCC - http://www.cancer.gov/cancertopics/pdq/screening/hepatocellular/HealthProfessional
Document Provenance and History
Document Author: Dr. Fazal Danish
Document Created: 30th March 2006
Document Edits: