LIVER CANCER (OCTOBER) DIAGNOSIS

>5th common CA, commonly by metastasis >CT & PET scan, MRI
>50-60 y/o, 2x in men >Transcutaneous intraoperative UTZ
>Serum AFP above 400mg/dL
LIVER
>stores sugars & produces bile SCREENING
>removes toxins & maintains blood clotting factors >Annual UTZ
>Serum AFP every 4months
RISK
1. Chronic liver c ell injury TUMOR MARKER
2. Hepatitis B and C >Serum AFP
3. Alcohol
4. Aflatoxins (Aspergius species) COMMON METASTASIS
>Peanuts, grains stored in moist >Lungs, bones, adrenal
5. Genetic mutations
>P53, P73, Rb, APC, DLC-1, BRCA2 SURGERY
>PTEN, c-mye, cylin D 1. Total hepatectomy
2. Partial hepatectomy (for early stage
PREVENTION hepatocarcinoma)
1. HBV vaccines to children 3. Liver transplantation – for single tumor less than
2. Alcohol reduction 5cm or 1- 3 tumors that’s less than 3cm
4. Cryosurgery – probe inserted, cooled w/ nitrogen
5 YEARS SURVIVAL RATE STAGES 5. Percutaneous ethanol injection – 95% ethanol
1 – 70-75% with UTZ guide, for 1-3 tumors less than 5cm, results
2 – 60% in tumor necrosis and ischemia.
3 - 40% 6. Radiofrequency ablation – guided w/ UTZ,
4 - 1 year alternative for cryosurgery, causes focal necrosis for
tumor via thermal energy.
CLASSIFICATION
1. Hepaptocellular carcinoma/hepatoma - common POST OP CARE
2. Cholangiocarcinoma – 10% bile duct cancer >Monitor bleeding, infection, respiratory failure
>Intrahepatic bile duct CA – begins in liver bile duct >Pain management & nutritional support
>Extrahepatic bile duct CA – ducts outside liver
3. Hepatoblastoma – infancy 3 years of age, RADIATION THERAPY (HCC – radiosensitive tumor)
unknown cause, 80% survival rate
4.Angiosarcoma – 1% of all liver CA, cause is CHEMOTHERAPY (Intra arterial)
lymphedema, 5 years survival rate >Floxurudin (FUDR), 5FU
>Doxorubicin, crysplatin, mytomycin C

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