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Carcinoma hepatocelular : diagnóstico, estadiamento e terapêutica
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O carcinoma hepatocelular é uma das principais causas de morte no mundo inteiro.
O factor mais importante para o desenvolvimento do carcinoma hepatocelular é a cirrose, sendo o consumo de álcool e a infecção pelo vírus da hepatite B e da hepatite C os principais responsáveis pelo seu desenvolvimento.
O diagnóstico é feito através de exames imagiológicos como a TC e a RMN; a biópsia hepática é, actualmente, pouco utilizada.
O rastreio deve ser encorajado nos indivíduos com factores de risco para o desenvolvimento de cirrose, sendo habitualmente realizado por ecografia.
Existem várias abordagens terapêuticas, mas a única com intuito curativo é o transplante hepático; outras terapêuticas incluem a ressecção tumoral, a ablação por radiofrequência, quimioembolização e imunoterapia.
O estadiamento correcto do tumor utilizando um dos vários sistemas de estadiamento disponíveis pode aumentar a sobrevida dos doentes.
Hepatocellular carcinoma is one of the leading causes of death by cancer in the entire world. Cirrhosis is the most important risk factor, with alcohol consumption and hepatitis B and C being the main causes for cirrhosis development. The diagnosis is made with help from imagiological techniques such as CT scan and MRI; liver biopsy is seldom used. Screening should be encouraged for those with risk factors for cirrhosis; the best screening method is the abdominal ultrassound. There are multiple treatment modalities but the only one that can cure the patient is still liver transplantation; other treatments include tumor ressection, radiofrequency ablation, microwave ablation, quimioembolization and immunotherapy. Correct staging of the tumour using one of the many available staging systems can guide the treatment and improve the survivability of the patient. The improvement of surgical and non-surgical treatment methods has lead to an overall increase in quality of life for patients with HCC.
Hepatocellular carcinoma is one of the leading causes of death by cancer in the entire world. Cirrhosis is the most important risk factor, with alcohol consumption and hepatitis B and C being the main causes for cirrhosis development. The diagnosis is made with help from imagiological techniques such as CT scan and MRI; liver biopsy is seldom used. Screening should be encouraged for those with risk factors for cirrhosis; the best screening method is the abdominal ultrassound. There are multiple treatment modalities but the only one that can cure the patient is still liver transplantation; other treatments include tumor ressection, radiofrequency ablation, microwave ablation, quimioembolization and immunotherapy. Correct staging of the tumour using one of the many available staging systems can guide the treatment and improve the survivability of the patient. The improvement of surgical and non-surgical treatment methods has lead to an overall increase in quality of life for patients with HCC.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019
Palavras-chave
Carcinoma hepatocelular Rastreio Estadiamento Quimioembolização Imunoterapia Imagiologia