Hepatocellular carcinoma (HCC, also called hepatoma) is a primary cancer (cancer) of the liver. Most cases are secondary to either hepatitis infection (usually hepatitis B or hepatitis C) or cirrhosis (alcoholism being the most common cause of hepatic cirrhosis). Treatment options and prognosis are dependent on many factors but especially on tumor size and staging. In Sub-Saharan Africa the commonly accepted prognosis is a median survival of 3 months from diagnosis. However, this is due to late presentation with large tumours. ==Epidemiology== The epidemiology of HCC exhibits two rough patterns, one in the Third World and another in the West. ===Third World=== In some parts of the world, such as Sub-Saharan Africa and Southeast Asia (and especially Taiwan and China) HCC is the commonest cancer, generally affecting men more than women, and with an age of onset between late teens and 30's. This variability is in part due to the different patterns of Hepatitis B transmission in different populations - infection at or around birth (as in Taiwan) predispose to earlier cancers than if people are infected later. The time between hepatitis B infection and development into HCC can be years even decades, but from diagnosis of HCC to death the average survival period is only 5.9 months, according to one Chinese study during the 1970-80s. HCC is one of the deadest cancers in China. Another unique type of HCC is not developed from Hepatitis B, but by eating ''Aspergillus flavus''-infected food (especially peanuts and corns stored during prolonged wet seasons) which produces aflatoxin, a poison proven to increase risk of HCC. ===Western countries=== Most malignant tumors of the liver discovered in Western patients are metastasis (spread) from tumors elsewhere. In the West, HCC is generally seen as rare cancer, normally of those with pre-existing liver disease. It is often detected by ultrasound screening, and so presents to health-care facilities much earlier than in Sub-Saharan Africa, for example. ==Diagnosis, screening and monitoring == In the western world, hepatocellular carcinoma (HCC) most commonly appears in a patient with chronic viral hepatitis (hepatitis B or hepatitis C, 20%) or with cirrhosis (about 80%). These patients commonly undergo surveillance with medical ultrasonography due to the cost-effectiveness. In patients with a higher suspicion of HCC (such as rising alpha-fetoprotein levels), the best method of diagnosis involves a computed axial tomography of the abdomen using radiocontrast agent and three-phase scanning (before contrast administration, immediately after contrast administration, and again after a delay) to increase the ability of the radiologist to detect small or subtle tumors. It is important to optimize the parameters of the CT examination, because the underlying liver disease that most HCC patients have can make the findings more difficult to appreciate. On CT, HCC can have three distinct patterns of growth: *A single large tumor *Multiple tumors *Poorly defined tumor with an infiltrative growth pattern Both calcifications and intralesional fat may be appreciated. In patients who have a contrast agent allergy or poor renal function, an magnetic resonance imaging of the abdomen is a more costly but effective substitute. Once imaged, diagnosis is confirmed by percutaneous biopsy and histopathologic analysis. ==Pathology== Macroscopically, liver cancer appears as a nodular or infiltrative tumor. The nodular type may be solitary (large mass) or multiple (when developed as a complication of cirrhosis). Tumor nodules are round to oval, grey or green (if the tumor produces bile), well circumscribed but not encapsulated. The diffuse type is poorly circumscribed and infiltrates the portal veins, or the hepatic veins (rarely). Microscopically, there are four architectural and cytological types (patterns) of hepatocellular carcinoma: fibrolamellar, pseudoglandular (adenoid), pleomorphic (giant cell) and clear cell. In well differentiated forms, tumor cells resemble hepatocytes, form trabeculae,cords and nests, and may contain bile pigment in cytoplasm. In poorly differentiated forms, malignant epithelial cells are discohesive, pleomorphic, anaplastic, giant. The tumor has a scant stroma and central necrosis because of the poor vascularization.[http://www.pathologyatlas.ro/Hepatocellular%20Carcinoma.html 1] ==Staging and prognosis== Important features that guide treament include: - * size * spread (staging (pathology)) * involvement of liver vessels * presence of a tumor capsule * presence of extrahepatic metastases * presence of daughter nodules * vascularity of the tumor MRI is the best imaging method to detect the presence of a tumor capsule. ==Treatment== Most of the research done on HCC reflects a very Western population, which limits the applicability of published studies to much of the world. * Surgery to remove the tumor can be use to treating small or slow-growing tumors if they are diagnosed early. Liver transplantation is used in more advanced disease limited to the liver. * Percutaneous ethanol injection (PEI) Among nonsurgical options, this is usually the treatment of choice for patients with small (3 cm or less in diameter) tumors. * Transcatheter arterial chemoembolization (TACE) is usually perform in the treatment of large tumors (larger than 3 cm and less than 4 cm in diameter) most frequently performed by intraarterially injecting an infusion of antineoplastic agents mixed with iodized oil (such as Lipiodol). * Radiofrequency ablation (RFA) uses high frequency radio-waves to ablate the tumour. * Combined PEI and TACE can used for tumors larger than 4 cm in diameter, although some Italian groups have had success with larger tumours using TACE alone. Other treatments have been tried, including tamoxifen, but none seem to have a great impact. ==Future directions== Current research includes the search for the genes that are disregulated in HCC. As similar research is yielding results in various other malignant diseases, it is hoped that identifying the abberant genes and the resultant proteins could lead to the identification of pharmacological interventions for HCC. ==Reference== * [http://liver.stanford.edu/index2.asp?lang=eng&page=res_recpub Genetic research in HCC] (Stanford Asian Liver Center) ==External links== ===Research links=== * [http://livercancer.stanford.edu/ Asian Liver Center at Stanford University] *[http://www.mdanderson.org/diseases/liver/ MD Anderson Liver Cancer Homepage] * [http://cpmcnet.columbia.edu/dept/gi/carcinoma.html HCC article by Howard J. Worman, MD, Columbia University] * [http://www.nlm.nih.gov/medlineplus/ency/article/000280.htm MedlinePlus] article about HCC * [http://www.pathologyatlas.ro/Hepatocellular%20Carcinoma.html Atlas of Pathology] (photos) *[http://www.cancer.gov/cancertopics/types/liver NCI Liver Cancer Homepage] *[http://researchportfolio.cancer.gov/cgi-bin/projectlist.pl?SID=339421 HCC Clinical Trials Search Engine] ===Patients' sites=== *[http://liver.andrewtorres.org Liver Cancer Toolbox - In Memory of 2nd Lt. Andrew Torres] *[http://www.bluefaery.org/ Treatment resources - In Memory of Adrienne Wilson] *[http://listserv.acor.org/archives/liver-onc.html Liver Cancer Support Group Online] Gastroenterology Oncology
>(an alternative name may be hepatoma) This was originally mentioned after the name. However, hepatomas are generally benign and harmless, which cannot be said about HCC User:Jfdwolff 00:05, 27 Feb 2004 (UTC) ==HCC== Please redirect from HCC. ''Hepatoma'' is an old name for primary hepatocellular carcinoma. [Yes, it's a misnomer.] User:Axl 18:18, 3 Jan 2005 (UTC) :So hepatoma should be a disambiguation. User:Jfdwolff | User_talk:Jfdwolff 21:00, 3 Jan 2005 (UTC) : Eh? With respect, I think that you made a mistake. Hepatoma = hepatocellular carcinoma. User:Axl 12:14, 5 Jan 2005 (UTC) So what do you call benign liver neoplasms, if not hepatoma? User:Jfdwolff | User_talk:Jfdwolff 16:04, 5 Jan 2005 (UTC) : I call them benign liver tumours/cysts/adenomas. User:Axl 09:54, 6 Jan 2005 (UTC) Good, it must be my training abroad that's leading to the confusion :-) User:Jfdwolff | User_talk:Jfdwolff 21:11, 6 Jan 2005 (UTC) : Hehe! :-) It is exactly this sort of confusion that caused the word (hepatoma) to fall into disuse. It doesn't comply with the general rule that solid epithelium-derived cancers should be designated 'carcinoma'. User:Axl 21:28, 6 Jan 2005 (UTC) ==Reverts== Dear Jfdwolff -- I think we need to revise the treatment section, or perhaps add a research heading, where we could link to clinical trials and current research -- the reason is that this may help patients -- What do you think? Anita Brenner :I agree, but please adhere to the WP:MOS. User:Jfdwolff | User_talk:Jfdwolff 06:29, 16 May 2005 (UTC) JFW: Your reverts eliminated my references to screening tests, Dr. So's genetics research, even reference sites for patients and this week's ASCO abstracts. I see by the history that you have reverted every time some one wanders in and posts a new link. All the links I have seen in the history, the ones that you erase, appear to be valid resources. You describe yourself as a physician, so I don't understand why you want to deprive patients of full access to the vast array of online resources, particularly when they may be of more benefit than the outdated summary you keep reverting to. What's the problem? Anita Brenner :Anita, please don't be insulted by something so minor, and try not to attack me without hearing me out. As you have recently joined you have not yet have seen how some articles are continuously "updated" by people wanting every detail mentioned of the most obscure research, theories and sometimes worse. :Wikipedia does not need external links. What Wikipedia needs is a well-written clear outline, not just of frontline research but of basic principles such as staging, histology and prognosis. Readers are much more helped by the conclusions of a recent review paper than by a deluge of links. :I hope this explains my "record" of removing added links. Please cooperate - I think this article needs a lot of work and it has a lot of worldwide implications (its highest incidence being in Southeast Asia). User:Jfdwolff | User_talk:Jfdwolff 12:39, 16 May 2005 (UTC) ''What Wikipedia needs is a well-written clear outline, not just of frontline research but of basic principles such as staging, histology and prognosis.'' That's very nice: are you actually going to do this or just remove anyone else's contributions? And since you've set yourself up as a veteran here, perhaps you ought to reacquaint yourself with Wikipedia:Please do not bite the newcomers and lose the supercilious attitude. --User:Calton | User talk:Calton 14:47, 16 May 2005 (UTC) :Oh, you've posted it here ''and'' on my talkpage? My response was intended to be constructive, so please do not make it sound differently. I'm honestly interested in Anita's expertise, and I don't think she needs you to come to her defense. User:Jfdwolff | User_talk:Jfdwolff 15:14, 16 May 2005 (UTC) --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- *Dear Calton, thank you for sticking up for me. I appreciate it. *This is long, but since it is my last post on Wikipedia, please bear with me. *Calton is correct, . I am not the first newcomer to attempt to contribute to this page, to try to bring it current, but, as the history of this and other page suggests, Jfdwolff, is brutal to newcomers. *Wikipedia had the opportunity to clear up a confusing area for people who are diagnosed with HCC. When I came upon this page, Jfdwolff had spent more time on political statements (he seems not to like the USA very much) than he did on current treatments and research. So in good faith, I thought I would make a contribution. But Jfdwolff kept reverting everything. *Because Jfdwolff chases away newcomers and automatically reverts most revisions, this page, in particular, is out of date. *Thanks to Calton, Jfdwolff has finally, kicking and screaming, grudgingly kept a few of the links that I contributed. *However, Jfdwolff has marginalized some of the links by relegating them to a special section. For example, Jfdwolff mischaracterizes the Wilson site as mere "patients' links." Unlike Jfdwolff, the Wilsons have raised money to publish a handbook for HCC patients. That booklet was written and approved by phyisicians on their board. Their booklet is more current and better written than anything jfdwolff has written here. *Jfdwolff did the same with my search engine at [http://liver.andrewtorres.org liver.andrewtorres.org]. [http://liver.andrewtorres.org liver.andrewtorres.org]is not a "patients" site. [http://liver.andrewtorres.org liver.andrewtorres.org] is a search engine that allows patient to keep current on clinical trials, the results of clinical trials, recent literature and emerging drugs. *Why did I write that page and why did I take the time to share all these resources here? Because the doubling time of HCC is 1-3 months and bioinformatics is essential. Patients and their physician need quick access to the latest research abstracts from ASCO, journal abstracts from Pubmed, clinical trial results. They also need to know what drugs are in the pipeline and how approved drugs can be used off-label. *But, life is too short to waste time where one is not wanted. Jfdwolff, I prefer to spend my time raising money for cancer research, and supporting the fine physicians and patients at the forefront of this disease. Some day Cancer will be a disease of the past. *And yes, JfdWolff, I do object to your citation to the Brazilian Journal of Medical Biology as a background review. The NIH, MD Anderson, NCI and ASCO sites are far better for background information. But they don't fit in to your political world view. Ciao, JfdWolff, You win. 17 May 2005 Anita Brenner ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- :Does anyone object against this article (Franca AV, Elias Junior J, Lima BL, Martinelli AL, Carrilho FJ. ''Diagnosis, staging and treatment of hepatocellular carcinoma.'' Braz J Med Biol Res 2004;37:1689-705. PMID 15517086) as a background review? User:Jfdwolff | User_talk:Jfdwolff 15:50, 16 May 2005 (UTC)
See other meanings of words starting from letter:
Words begining with Hepatocellular_carcinoma:
Hepatocellular_carcinoma
Hepatocellular_carcinoma
Hepatocellular carcinoma
Hepatocellular carcinoma (HCC, also called hepatoma) is a primary cancer (cancer) of the liver. Most cases are secondary to either hepatitis infection (usually hepatitis B or hepatitis C) or cirrhosis (alcoholism being the most common cause of hepatic cirrhosis). Treatment options and prognosis are dependent on many factors but especially on tumor size and staging. In Sub-Saharan Africa the commonly accepted prognosis is a median survival of 3 months from diagnosis. However, this is due to late presentation with large tumours. ==Epidemiology== The epidemiology of HCC exhibits two rough patterns, one in the Third World and another in the West. ===Third World=== In some parts of the world, such as Sub-Saharan Africa and Southeast Asia (and especially Taiwan and China) HCC is the commonest cancer, generally affecting men more than women, and with an age of onset between late teens and 30's. This variability is in part due to the different patterns of Hepatitis B transmission in different populations - infection at or around birth (as in Taiwan) predispose to earlier cancers than if people are infected later. The time between hepatitis B infection and development into HCC can be years even decades, but from diagnosis of HCC to death the average survival period is only 5.9 months, according to one Chinese study during the 1970-80s. HCC is one of the deadest cancers in China. Another unique type of HCC is not developed from Hepatitis B, but by eating ''Aspergillus flavus''-infected food (especially peanuts and corns stored during prolonged wet seasons) which produces aflatoxin, a poison proven to increase risk of HCC. ===Western countries=== Most malignant tumors of the liver discovered in Western patients are metastasis (spread) from tumors elsewhere. In the West, HCC is generally seen as rare cancer, normally of those with pre-existing liver disease. It is often detected by ultrasound screening, and so presents to health-care facilities much earlier than in Sub-Saharan Africa, for example. ==Diagnosis, screening and monitoring == In the western world, hepatocellular carcinoma (HCC) most commonly appears in a patient with chronic viral hepatitis (hepatitis B or hepatitis C, 20%) or with cirrhosis (about 80%). These patients commonly undergo surveillance with medical ultrasonography due to the cost-effectiveness. In patients with a higher suspicion of HCC (such as rising alpha-fetoprotein levels), the best method of diagnosis involves a computed axial tomography of the abdomen using radiocontrast agent and three-phase scanning (before contrast administration, immediately after contrast administration, and again after a delay) to increase the ability of the radiologist to detect small or subtle tumors. It is important to optimize the parameters of the CT examination, because the underlying liver disease that most HCC patients have can make the findings more difficult to appreciate. On CT, HCC can have three distinct patterns of growth: *A single large tumor *Multiple tumors *Poorly defined tumor with an infiltrative growth pattern Both calcifications and intralesional fat may be appreciated. In patients who have a contrast agent allergy or poor renal function, an magnetic resonance imaging of the abdomen is a more costly but effective substitute. Once imaged, diagnosis is confirmed by percutaneous biopsy and histopathologic analysis. ==Pathology== Macroscopically, liver cancer appears as a nodular or infiltrative tumor. The nodular type may be solitary (large mass) or multiple (when developed as a complication of cirrhosis). Tumor nodules are round to oval, grey or green (if the tumor produces bile), well circumscribed but not encapsulated. The diffuse type is poorly circumscribed and infiltrates the portal veins, or the hepatic veins (rarely). Microscopically, there are four architectural and cytological types (patterns) of hepatocellular carcinoma: fibrolamellar, pseudoglandular (adenoid), pleomorphic (giant cell) and clear cell. In well differentiated forms, tumor cells resemble hepatocytes, form trabeculae,cords and nests, and may contain bile pigment in cytoplasm. In poorly differentiated forms, malignant epithelial cells are discohesive, pleomorphic, anaplastic, giant. The tumor has a scant stroma and central necrosis because of the poor vascularization.[http://www.pathologyatlas.ro/Hepatocellular%20Carcinoma.html 1] ==Staging and prognosis== Important features that guide treament include: - * size * spread (staging (pathology)) * involvement of liver vessels * presence of a tumor capsule * presence of extrahepatic metastases * presence of daughter nodules * vascularity of the tumor MRI is the best imaging method to detect the presence of a tumor capsule. ==Treatment== Most of the research done on HCC reflects a very Western population, which limits the applicability of published studies to much of the world. * Surgery to remove the tumor can be use to treating small or slow-growing tumors if they are diagnosed early. Liver transplantation is used in more advanced disease limited to the liver. * Percutaneous ethanol injection (PEI) Among nonsurgical options, this is usually the treatment of choice for patients with small (3 cm or less in diameter) tumors. * Transcatheter arterial chemoembolization (TACE) is usually perform in the treatment of large tumors (larger than 3 cm and less than 4 cm in diameter) most frequently performed by intraarterially injecting an infusion of antineoplastic agents mixed with iodized oil (such as Lipiodol). * Radiofrequency ablation (RFA) uses high frequency radio-waves to ablate the tumour. * Combined PEI and TACE can used for tumors larger than 4 cm in diameter, although some Italian groups have had success with larger tumours using TACE alone. Other treatments have been tried, including tamoxifen, but none seem to have a great impact. ==Future directions== Current research includes the search for the genes that are disregulated in HCC. As similar research is yielding results in various other malignant diseases, it is hoped that identifying the abberant genes and the resultant proteins could lead to the identification of pharmacological interventions for HCC. ==Reference== * [http://liver.stanford.edu/index2.asp?lang=eng&page=res_recpub Genetic research in HCC] (Stanford Asian Liver Center) ==External links== ===Research links=== * [http://livercancer.stanford.edu/ Asian Liver Center at Stanford University] *[http://www.mdanderson.org/diseases/liver/ MD Anderson Liver Cancer Homepage] * [http://cpmcnet.columbia.edu/dept/gi/carcinoma.html HCC article by Howard J. Worman, MD, Columbia University] * [http://www.nlm.nih.gov/medlineplus/ency/article/000280.htm MedlinePlus] article about HCC * [http://www.pathologyatlas.ro/Hepatocellular%20Carcinoma.html Atlas of Pathology] (photos) *[http://www.cancer.gov/cancertopics/types/liver NCI Liver Cancer Homepage] *[http://researchportfolio.cancer.gov/cgi-bin/projectlist.pl?SID=339421 HCC Clinical Trials Search Engine] ===Patients' sites=== *[http://liver.andrewtorres.org Liver Cancer Toolbox - In Memory of 2nd Lt. Andrew Torres] *[http://www.bluefaery.org/ Treatment resources - In Memory of Adrienne Wilson] *[http://listserv.acor.org/archives/liver-onc.html Liver Cancer Support Group Online] Gastroenterology Oncology
Hepatocellular carcinoma
>(an alternative name may be hepatoma) This was originally mentioned after the name. However, hepatomas are generally benign and harmless, which cannot be said about HCC User:Jfdwolff 00:05, 27 Feb 2004 (UTC) ==HCC== Please redirect from HCC. ''Hepatoma'' is an old name for primary hepatocellular carcinoma. [Yes, it's a misnomer.] User:Axl 18:18, 3 Jan 2005 (UTC) :So hepatoma should be a disambiguation. User:Jfdwolff | User_talk:Jfdwolff 21:00, 3 Jan 2005 (UTC) : Eh? With respect, I think that you made a mistake. Hepatoma = hepatocellular carcinoma. User:Axl 12:14, 5 Jan 2005 (UTC) So what do you call benign liver neoplasms, if not hepatoma? User:Jfdwolff | User_talk:Jfdwolff 16:04, 5 Jan 2005 (UTC) : I call them benign liver tumours/cysts/adenomas. User:Axl 09:54, 6 Jan 2005 (UTC) Good, it must be my training abroad that's leading to the confusion :-) User:Jfdwolff | User_talk:Jfdwolff 21:11, 6 Jan 2005 (UTC) : Hehe! :-) It is exactly this sort of confusion that caused the word (hepatoma) to fall into disuse. It doesn't comply with the general rule that solid epithelium-derived cancers should be designated 'carcinoma'. User:Axl 21:28, 6 Jan 2005 (UTC) ==Reverts== Dear Jfdwolff -- I think we need to revise the treatment section, or perhaps add a research heading, where we could link to clinical trials and current research -- the reason is that this may help patients -- What do you think? Anita Brenner :I agree, but please adhere to the WP:MOS. User:Jfdwolff | User_talk:Jfdwolff 06:29, 16 May 2005 (UTC) JFW: Your reverts eliminated my references to screening tests, Dr. So's genetics research, even reference sites for patients and this week's ASCO abstracts. I see by the history that you have reverted every time some one wanders in and posts a new link. All the links I have seen in the history, the ones that you erase, appear to be valid resources. You describe yourself as a physician, so I don't understand why you want to deprive patients of full access to the vast array of online resources, particularly when they may be of more benefit than the outdated summary you keep reverting to. What's the problem? Anita Brenner :Anita, please don't be insulted by something so minor, and try not to attack me without hearing me out. As you have recently joined you have not yet have seen how some articles are continuously "updated" by people wanting every detail mentioned of the most obscure research, theories and sometimes worse. :Wikipedia does not need external links. What Wikipedia needs is a well-written clear outline, not just of frontline research but of basic principles such as staging, histology and prognosis. Readers are much more helped by the conclusions of a recent review paper than by a deluge of links. :I hope this explains my "record" of removing added links. Please cooperate - I think this article needs a lot of work and it has a lot of worldwide implications (its highest incidence being in Southeast Asia). User:Jfdwolff | User_talk:Jfdwolff 12:39, 16 May 2005 (UTC) ''What Wikipedia needs is a well-written clear outline, not just of frontline research but of basic principles such as staging, histology and prognosis.'' That's very nice: are you actually going to do this or just remove anyone else's contributions? And since you've set yourself up as a veteran here, perhaps you ought to reacquaint yourself with Wikipedia:Please do not bite the newcomers and lose the supercilious attitude. --User:Calton | User talk:Calton 14:47, 16 May 2005 (UTC) :Oh, you've posted it here ''and'' on my talkpage? My response was intended to be constructive, so please do not make it sound differently. I'm honestly interested in Anita's expertise, and I don't think she needs you to come to her defense. User:Jfdwolff | User_talk:Jfdwolff 15:14, 16 May 2005 (UTC) --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- *Dear Calton, thank you for sticking up for me. I appreciate it. *This is long, but since it is my last post on Wikipedia, please bear with me. *Calton is correct, . I am not the first newcomer to attempt to contribute to this page, to try to bring it current, but, as the history of this and other page suggests, Jfdwolff, is brutal to newcomers. *Wikipedia had the opportunity to clear up a confusing area for people who are diagnosed with HCC. When I came upon this page, Jfdwolff had spent more time on political statements (he seems not to like the USA very much) than he did on current treatments and research. So in good faith, I thought I would make a contribution. But Jfdwolff kept reverting everything. *Because Jfdwolff chases away newcomers and automatically reverts most revisions, this page, in particular, is out of date. *Thanks to Calton, Jfdwolff has finally, kicking and screaming, grudgingly kept a few of the links that I contributed. *However, Jfdwolff has marginalized some of the links by relegating them to a special section. For example, Jfdwolff mischaracterizes the Wilson site as mere "patients' links." Unlike Jfdwolff, the Wilsons have raised money to publish a handbook for HCC patients. That booklet was written and approved by phyisicians on their board. Their booklet is more current and better written than anything jfdwolff has written here. *Jfdwolff did the same with my search engine at [http://liver.andrewtorres.org liver.andrewtorres.org]. [http://liver.andrewtorres.org liver.andrewtorres.org]is not a "patients" site. [http://liver.andrewtorres.org liver.andrewtorres.org] is a search engine that allows patient to keep current on clinical trials, the results of clinical trials, recent literature and emerging drugs. *Why did I write that page and why did I take the time to share all these resources here? Because the doubling time of HCC is 1-3 months and bioinformatics is essential. Patients and their physician need quick access to the latest research abstracts from ASCO, journal abstracts from Pubmed, clinical trial results. They also need to know what drugs are in the pipeline and how approved drugs can be used off-label. *But, life is too short to waste time where one is not wanted. Jfdwolff, I prefer to spend my time raising money for cancer research, and supporting the fine physicians and patients at the forefront of this disease. Some day Cancer will be a disease of the past. *And yes, JfdWolff, I do object to your citation to the Brazilian Journal of Medical Biology as a background review. The NIH, MD Anderson, NCI and ASCO sites are far better for background information. But they don't fit in to your political world view. Ciao, JfdWolff, You win. 17 May 2005 Anita Brenner ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- :Does anyone object against this article (Franca AV, Elias Junior J, Lima BL, Martinelli AL, Carrilho FJ. ''Diagnosis, staging and treatment of hepatocellular carcinoma.'' Braz J Med Biol Res 2004;37:1689-705. PMID 15517086) as a background review? User:Jfdwolff | User_talk:Jfdwolff 15:50, 16 May 2005 (UTC)
See other meanings of words starting from letter:
H
HA | HB | HC | HD | HE | HF | HG | HI | HJ | HK | HL | HM | HN | HO | HP | HR | HS | HT | HU | HW | HX | HY | HZ |Words begining with Hepatocellular_carcinoma:
Hepatocellular_carcinoma
Hepatocellular_carcinoma
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