Hepatocarcinoma, also known as hepatocellular carcinoma (HCC), is the most common primary malignant tumor of the liver. This type of cancer originates in the main cells of the liver, called hepatocytes.
The liver is a vital organ with many functions, such as filtering toxins from the blood and producing bile for digestion. HCC occurs when liver cells develop mutations in their DNA, leading to uncontrolled growth and the formation of a tumor. This type of cancer can seriously affect health, as it interferes with normal liver function and can spread to other parts of the body.
Symptoms of hepatocarcinoma
Early detection of hepatocarcinoma can be challenging, as it often does not present noticeable symptoms in its early stages. However, as the disease progresses, certain signs may indicate the presence of a problem. It is crucial to be aware of these symptoms and seek medical attention if any of them are experienced. Common symptoms include:
Weight loss for no apparent reason.
Weakness or fatigue.
Yellowing of the skin and eyes (jaundice).
Ascites (accumulation of fluid in the abdomen).
Abdominal swelling.
Nausea and vomiting.
Light-colored stools.
It can sometimes cause abdominal pain.
It is important to remember that these symptoms can be caused by other conditions. If you experience any of these symptoms, it is essential to consult a doctor for an accurate diagnosis.
Clasificación del hepatocarcinoma
La clasificación del hepatocarcinoma es un proceso complejo que implica evaluar varios factores para determinar la extensión y agresividad del cáncer. Esta clasificación es fundamental para guiar las decisiones de tratamiento y predecir el pronóstico del paciente. A continuación, se describen algunos de los sistemas de clasificación más utilizados:
Clasificación de Child-Pugh: evalúa la función hepática en pacientes con cirrosis. Se basa en cinco factores: bilirrubina, albúmina, ascitis, encefalopatía y tiempo de protrombina. Los pacientes se clasifican en clase A (bien compensado), clase B (compromiso funcional significativo) o clase C (descompensado).
Sistema de estadificación de Barcelona (BCLC): combina factores como el tamaño del tumor, la función hepática y el estado general del paciente para guiar las decisiones de tratamiento. Este sistema clasifica a los pacientes en cinco estadios: 0 (muy temprano), A (temprano), B (intermedio), C (avanzado) y D (terminal).
Estadio TNM: este sistema clasifica el cáncer según el tamaño del tumor (T), la afectación de los ganglios linfáticos (N) y la presencia de metástasis (M). Ésta última es menos utilizada que la BCLC.
Causas del hepatocarcinoma
A pesar de los avances en la investigación, las causas exactas del hepatocarcinoma aún no se comprenden completamente. Sin embargo, se han identificado varios factores que pueden aumentar el riesgo de desarrollar esta enfermedad. En muchos casos, el CHC se desarrolla en hígados ya dañados por otras enfermedades, como la cirrosis. La cirrosis es una cicatrización del hígado que puede ser causada por:
Infección crónica por el virus de la hepatitis B (VHB) o el virus de la hepatitis C (VHC).
Consumo excesivo de alcohol.
Enfermedad del hígado graso no alcohólica (EHGNA).
Hemocromatosis (acumulación de hierro en el hígado).Classification of hepatocarcinoma
The classification of hepatocarcinoma is a complex process that involves evaluating several factors to determine the extent and aggressiveness of the cancer. This classification is essential for guiding treatment decisions and predicting the patient’s prognosis. The following are some of the most commonly used classification systems:
Child-Pugh classification: evaluates liver function in patients with cirrhosis. It is based on five factors: bilirubin, albumin, ascites, encephalopathy, and prothrombin time. Patients are classified into class A (well compensated), class B (significant functional impairment), or class C (decompensated).
Barcelona Clinic Liver Cancer (BCLC) staging system: it combines factors such as tumor size, liver function, and the patient’s overall condition to guide treatment decisions. This system classifies patients into five stages: 0 (very early), A (early), B (intermediate), C (advanced), and D (terminal).
TNM staging: this system classifies cancer based on tumor size (T), lymph node involvement (N), and the presence of metastasis (M). The latter is less commonly used than the BCLC.
Causes of hepatocarcinoma
Despite advances in research, the exact causes of hepatocarcinoma are still not fully understood. However, various factors have been identified that can increase the risk of developing this disease. In many cases, HCC develops in livers already damaged by other diseases, such as cirrhosis. Cirrhosis is scarring of the liver that can be caused by:
Chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV).
If left untreated, hepatocarcinoma can lead to various complications that affect the health and quality of life of patients. It is important to seek medical advice if the disease is suspected in order to avoid short- and long-term complications. Common complications include:
Cancer spread: HCC can spread to other parts of the body, such as the lungs, bones, and lymph nodes.
Liver failure: as cancer damages the liver, it may stop functioning properly.
Bleeding: HCC can cause internal bleeding, especially in the esophagus or stomach.
Pain: cancer can cause severe abdominal pain.
Ascites: accumulation of fluid in the abdomen.
Diagnosis of hepatocarcinoma
An accurate and early diagnosis is essential for effective treatment of hepatocarcinoma. The diagnostic process generally includes a combination of physical examinations, blood tests, and imaging tests. It is important to note that the diagnosis must be made by a qualified medical professional. Common diagnostic methods and procedures include:
Physical examination: the doctor will palpate the abdomen to detect any abnormalities in the liver.
Blood tests: tests can be performed to evaluate liver function and look for tumor markers, such as alpha-fetoprotein (AFP). AFP is a protein produced by the liver that may be elevated in patients with hepatocellular carcinoma. However, it is important to note that AFP can also be elevated in other conditions, so it is not a specific marker for HCC.
Abdominal ultrasound: they allow doctors to visualize the liver and detect tumors. Ultrasound is a non-invasive test that uses sound waves to create images of the liver.
Computerized Tomography (CT scan): it provides detailed images of the liver and other organs. CT uses X-rays to create cross-sectional images of the body.
Magnetic Resonance Imaging (MRI): it offers high-resolution images of the liver. MRI uses powerful magnets and radio waves to create images of the body.
Liver biopsy: a sample of liver tissue is taken for examination under a microscope. Liver biopsy is the most accurate method to confirm the diagnosis of hepatocarcinoma.
Treatment of hepatocarcinoma
The treatment of hepatocellular carcinoma is individualized according to the stage of the cancer, liver function, and the patient’s overall health status. A multidisciplinary approach, involving hepatologists, medical oncologists, radiation oncologists, surgeons, and interventional radiologists, is essential for comprehensive and personalized treatment. Treatment options include:
Surgery: it is an option if the tumor is small and located in the liver, and a liver resection can be performed, which consists of the surgical removal of the part of the liver that contains the tumor, or a liver transplant, which consists of replacing the diseased liver with a healthy liver from a donor, and may be an option for patients with cirrhosis and early-stage hepatocellular carcinoma. At HM Hospitales, we have surgeons who are experts in liver surgery.
Targeted therapies: drugs that attack cancer cells without harming healthy cells. These drugs can block the growth and spread of cancer.
Immunotherapy: medications that help the immune system fight cancer. Immunotherapy can stimulate the immune system to attack cancer cells.
Radiotherapy: it uses high-energy radiation to destroy cancer cells. Radiation therapy can be administered externally or internally.
Local therapies: these therapies target the tumor directly. Among these is radiofrequency ablation, which involves the use of heat to destroy cancer cells and transarterial chemoembolization (TACE), where chemotherapy drugs are administered directly into the tumor through a catheter.
At HM Hospitales, a multidisciplinary team of specialists works together to provide comprehensive and personalized treatment for each patient with hepatocarcinoma. This team may include hepatologists, medical oncologists, radiation oncologists, surgeons, and interventional radiologists.
Remember that this article is for informational purposes only and does not replace professional medical advice. If you suspect you have hepatocarcinoma, consult a specialist to obtain an accurate diagnosis and an appropriate treatment plan tailored to your needs.
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