HEPATOCELLULAR CARCINOMA (HCC) EXAM
QUESTIONS AND ACCURATE ANSWERS
What is Hepatocellular carcinoma (HCC) commonly associated with?
Liver disease, particularly cirrhosis and hepatitis B and C.
How can early detection of HCC be achieved?
Through screening of patients with chronic hepatitis infection and those with cirrhosis.
What is the common method of diagnosing HCC?
Diagnosis is commonly clinical, based on AFP (alpha-fetoprotein) levels and imaging
characteristics.
What staging system is used for HCC?
The BCLC (Barcelona Clinic Liver Cancer) staging system.
What are the treatment options for early-stage HCC?
Surgical resection or liver transplantation if within Milan criteria.
What are the Milan criteria for liver transplantation in HCC?
1 tumor ≤ 5 cm or 2-3 tumors each ≤ 3 cm; no extrahepatic disease or vascular invasion.
What treatments are available for patients with multiple or larger tumors?
Focal therapies including RFA (radiofrequency ablation), TACE (transarterial
chemoembolization), radioembolization (Y90), or RT (radiotherapy).
What systemic agents may improve overall survival in advanced HCC?
Atezolizumab/bevacizumab, durvalumab/tremelimumab, or other systemic agents.
What is the global ranking of HCC as a cause of cancer death in men?
It is the second leading cause of cancer death worldwide in men.
What is the incidence rate of primary liver cancer in the United States?
8.8 cases per 100,000.
What are the primary risk factors associated with HCC?
Cirrhosis, hepatitis B (HBV), and hepatitis C (HCV) infections.
How does treatment of viral infections affect cancer risk in HBV and HCV?
It reduces future cancer risk by 50% to 60% in HBV and 70% in HCV.
, What are some other risk factors for HCC?
Male gender, diabetes, smoking, hereditary hemochromatosis, alcohol use, obesity, and exposure
to environmental toxins.
What is the largest solid organ in the body?
The liver.
How is the liver anatomically divided?
Based on vasculature into eight segments.
What is the primary blood supply to the liver?
The portal vein (75%) and the hepatic artery (25%).
What is the significance of increased portal venous pressure?
It potentiates the development of varices.
What is the role of AFP in HCC diagnosis?
AFP levels are used as a clinical marker for diagnosis.
What imaging techniques are recommended for HCC diagnosis?
Four-phase CT or MRI to evaluate lesions.
What are the key prognostic factors for HCC?
Tumor stage, functional status, Child-Pugh score, and presence of metastatic disease.
What does the Child-Pugh classification assess?
It assesses underlying liver function.
What is the significance of the albumin-bilirubin (ALBI) grade?
It is a validated alternative to the Child-Pugh classification for assessing liver function.
What does BCLC staging include?
Patient performance status, liver function, and tumor characteristics.
What is the recommended follow-up for lesions <1 cm on ultrasound?
A repeat ultrasound in 3 months.
What is the compliance rate for screening with AFP and ultrasound in a study of 18,816
patients?
58% compliance rate.
What is the 2-year overall survival rate for Child-Pugh Class A, B, and C?
QUESTIONS AND ACCURATE ANSWERS
What is Hepatocellular carcinoma (HCC) commonly associated with?
Liver disease, particularly cirrhosis and hepatitis B and C.
How can early detection of HCC be achieved?
Through screening of patients with chronic hepatitis infection and those with cirrhosis.
What is the common method of diagnosing HCC?
Diagnosis is commonly clinical, based on AFP (alpha-fetoprotein) levels and imaging
characteristics.
What staging system is used for HCC?
The BCLC (Barcelona Clinic Liver Cancer) staging system.
What are the treatment options for early-stage HCC?
Surgical resection or liver transplantation if within Milan criteria.
What are the Milan criteria for liver transplantation in HCC?
1 tumor ≤ 5 cm or 2-3 tumors each ≤ 3 cm; no extrahepatic disease or vascular invasion.
What treatments are available for patients with multiple or larger tumors?
Focal therapies including RFA (radiofrequency ablation), TACE (transarterial
chemoembolization), radioembolization (Y90), or RT (radiotherapy).
What systemic agents may improve overall survival in advanced HCC?
Atezolizumab/bevacizumab, durvalumab/tremelimumab, or other systemic agents.
What is the global ranking of HCC as a cause of cancer death in men?
It is the second leading cause of cancer death worldwide in men.
What is the incidence rate of primary liver cancer in the United States?
8.8 cases per 100,000.
What are the primary risk factors associated with HCC?
Cirrhosis, hepatitis B (HBV), and hepatitis C (HCV) infections.
How does treatment of viral infections affect cancer risk in HBV and HCV?
It reduces future cancer risk by 50% to 60% in HBV and 70% in HCV.
, What are some other risk factors for HCC?
Male gender, diabetes, smoking, hereditary hemochromatosis, alcohol use, obesity, and exposure
to environmental toxins.
What is the largest solid organ in the body?
The liver.
How is the liver anatomically divided?
Based on vasculature into eight segments.
What is the primary blood supply to the liver?
The portal vein (75%) and the hepatic artery (25%).
What is the significance of increased portal venous pressure?
It potentiates the development of varices.
What is the role of AFP in HCC diagnosis?
AFP levels are used as a clinical marker for diagnosis.
What imaging techniques are recommended for HCC diagnosis?
Four-phase CT or MRI to evaluate lesions.
What are the key prognostic factors for HCC?
Tumor stage, functional status, Child-Pugh score, and presence of metastatic disease.
What does the Child-Pugh classification assess?
It assesses underlying liver function.
What is the significance of the albumin-bilirubin (ALBI) grade?
It is a validated alternative to the Child-Pugh classification for assessing liver function.
What does BCLC staging include?
Patient performance status, liver function, and tumor characteristics.
What is the recommended follow-up for lesions <1 cm on ultrasound?
A repeat ultrasound in 3 months.
What is the compliance rate for screening with AFP and ultrasound in a study of 18,816
patients?
58% compliance rate.
What is the 2-year overall survival rate for Child-Pugh Class A, B, and C?
