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Carcinogenesis Advance Access published online on May 29, 2008
Carcinogenesis, doi:10.1093/carcin/bgn113
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© The Author 2008. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Recent Advances in the Natural History of Hepatocellular Carcinoma

F. Trevisani, MD, M.C. Cantarini, MD, J.R. Wands, MD* and M. Bernardi, MD

Dipartimento di Medicina Clinica, Università di Bologna, via Albertoni 15, 40138 Bologna, Italy

Corresponding author: Prof. Franco Trevisani, Dipartimento di Malattie Apparato Digerente e Medicina Interna, Unità di Semeiotica Medica, Via Albertoni, 15, 40138 Bologna, Tel. +39 051 636.2923, Fax +39 051 636.2930, E-mail: franco.trevisani{at}unibo.it

Ongoing advances in liver disease management and basic research in recent years have changed our knowledge of the natural history of hepatocellular carcinoma (HCC). Indeed, the natural history of this tumor is fairly long and covers a preclinical and a clinical phase. Some of the biological steps involved in cell transformation and different carcinogenic pathways have been identified, disclosing potential novel markers for HCC. Following the progress in surveillance and early diagnosis, much more is now known about precancerous lesions and the process leading to overt HCC, including growth patterns, dedifferentiation and neoangiogenenesis. In particular, research has focused on clinical and biological factors predicting tumor aggressiveness and patients' prognosis. Lastly, clinical studies have described tumor presentation, evolution and causes of patients' death and how the new knowledge has influenced clinical management and patients' survival in recent years. By addressing ten key questions, this review will summarize well-established and novel features of the natural history of HCC.

Key Words: hepatocellular carcinoma • natural history • carcinogenesis • prognosis • cirrhosis

* The Warren Alpert Medical School of Brown University, Liver Research Center, Rhode Island Hospital, 55 Claverick Street, 4th floor, Providence RI 02903, USA

Received February 19, 2008; revised April 7, 2008; accepted April 30, 2008.


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