The use of ultrasonography in the diagnosis, staging and therapy of hepatocellular carcinoma - Essay Example

Also, the incidence of HCC worldwide varies according to the prevalence of hepatitis B and C infections. In the US, the incidence is 4 cases per 100,000. In areas such as Asia and sub-Saharan Africa, the rates are as high as 120 cases per 100,000 (Stuart, 2006). It occurs more commonly in men than in women. The median age of diagnosis the United States and Europe is 65 years. In the African and Asian countries where the incidence is high, the age of diagnosis can be even in the 4th and 5th decades.

The median survival from the time of diagnosis is generally 6 months. Length of survival depends largely on the extent of cirrhosis in the liver. Cirrhotic patients have shorter survival times, and in cases of portal vein occlusion, the prognosis is even worse (Stuart, 2006). Cure through surgery is possible in less than 5% of all patients. Due to the multifocality nature of the tumor and invasion of the tumor into portal vein, surgical resection can be performed only in 20% cases (Wu, 2005).

Death in HCC occurs due to hepatic failure, cachexia, variceal bleeding or even due to tumor rupture and bleeding into the peritoneum. The patients generally present with symptoms related to cirrhosis like pruritus, jaundice, variceal bleeding, cachexia, pain in the hepatic region, increasing abdominal girth, splenomegaly and hepatic encephalopathy (Stuart, 2006). The etiology of cirrhosis could be alcohol induced, infections due to Hepatitis B or C, hemochromatosis, aflatoxin or even primary biliary cirrhosis, androgenic steroids, primary sclerosing cholangitis, 1-antitrypsin deficiency, Thorotrast radioactive contrast, oral contraceptives, and porphyria cutanea tarda (Stuart, 2006).

In about 80% of cases, cirrhosis is the cause. However, 20% of cases are due to noncirrhotic, nonviral causes (Ulmer, 2000). Liver being the largest organ in the body varies considerably in size and configuration from