Prevención del Carcinoma Hepatocelular: Recomendaciones internacionales, una revisión basada en la evidencia.
DOI:
https://doi.org/10.52611/confluencia.num2.2023.1005Palabras clave:
Prevención primaria, Prevención secundaria, Prevención terciaria, Carcinoma hepatocelularResumen
Introducción: El carcinoma hepatocelular representa un importante desafío de salud a nivel mundial y en Chile. A pesar de una disminución en la letalidad, otros indicadores como la mortalidad, incidencia y tasa de egresos continúan en aumento en el país. Objetivo: Realizar una revisión bibliográfica de las intervenciones internacionales en los diferentes niveles de prevención para carcinoma hepatocelular, con el propósito visualizar estrategias de prevención en Chile frente a la ausencia de una guía nacional que las sintetice. Resultado y Discusión: La prevención primaria se enfoca en evitar la cirrosis hepática, principal factor de riesgo para el carcinoma hepatocelular y la esteatosis hepática no alcohólica. Se destaca la importancia de educar a la población sobre consumo de alcohol, dieta, ejercicio e infecciones por virus de la hepatitis B y C. Se recomienda el uso de encuestas como el Alcohol Use Disorders Identification Test y legislación para reducir el consumo de alcohol. Se resalta la importancia de la vigilancia poblacional y la identificación de poblaciones de riesgo. La pesquisa temprana es crucial, el tamizaje se realiza con ecografía abdominal y el uso de alfafetoproteína es controversial. Se recomienda el uso de tomografía computarizada o resonancia magnética para el diagnóstico. El tratamiento depende del estadío, función hepática y comorbilidades del paciente. Las opciones incluyen resección, trasplante, ablación y terapias sistémicas. Conclusión: Esta revisión subraya la importancia de la educación, el tamizaje y el acceso a tratamientos adecuados para combatir el carcinoma hepatocelular y reducir su impacto en la salud pública.
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Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F. Global Cancer Observatory: Cancer Today [Internet]. 2021;Available from: https://gco.iarc.fr/today,
Lecuna Aguerrevere P. Hepatocarcinoma. G E N [Internet] 2009 [cited 2022 Jun 24];63(4):298–301. Available from: http://ve.scielo.org/scielo.php?script=sci_abstract&pid=S0016-35032009000400013&lng=es &nrm=iso&tlng=es
Goodman ZD. Neoplasms of the liver [Internet]. Modern Pathology. 2007;20(S1):S49–60. Available from: http://dx.doi.org/10.1038/modpathol.3800682
Quaglia A. Hepatocellular carcinoma: a review of diagnostic challenges for the pathologist. J Hepatocell Carcinoma [Internet] 2018;5:99–108. Available from: http://dx.doi.org/10.2147/JHC.S159808
Singh S, Singh PP, Roberts LR, Sanchez W. Chemopreventive strategies in hepatocellular carcinoma [Internet]. Nature Reviews Gastroenterology & Hepatology. 2014;11(1):45–54. Available from: http://dx.doi.org/10.1038/nrgastro.2013.143
Thiele M, Albillos A, Abazi R, Wiest R, Gluud LL, Krag A. Non-selective beta-blockers may reduce risk of hepatocellular carcinoma: a meta-analysis of randomized trials. Liver Int [Internet] 2015;35(8):2009–16. Available from: http://dx.doi.org/10.1111/liv.12782
George ES, Sood S, Broughton A, et al. The Association between Diet and Hepatocellular Carcinoma: A Systematic Review. Nutrients [Internet] 2021;13(1). Available from: http://dx.doi.org/10.3390/nu13010172
Simon TG, Chan AT. Lifestyle and Environmental Approaches for the Primary Prevention of Hepatocellular Carcinoma. Clin Liver Dis [Internet] 2020;24(4):549–76. Available from: http://dx.doi.org/10.1016/j.cld.2020.06.002
Caini S, Del Riccio M, Vettori V, et al. The Prognostic Impact of Quitting Smoking at or around Diagnosis on the Survival of Patients with Gastrointestinal Cancers: A Systematic Literature Review. Cancers [Internet] 2022 [citado 2022 oct 10];14(16). Available from: https://pubmed.ncbi.nlm.nih.gov/36010851/
Rivas S, Ribao M, Raimann M, Diaz M, Aguero B. Análisis comparativo de las medidas de prevención nacionales e internacionales para cirrosis hepática alcohólica. Revista Confluencia [Internet] 2022 [citado 2022 sep 6];5(1):84–91. Available from: http://repositorio.udd.cl/handle/11447/6506
Lefio LÁ, Villarroel SR, Rebolledo C. Intervenciones eficaces en consumo problemático de alcohol y otras drogas. de salud pública [Internet] 2013;Available from: https://www.scielosp.org/article/ssm/content/raw/?resource_ssm_path=/media/assets/rpsp/v34n4/07.pdf
Monasor R, Jiménez M, Palomo T. Intervenciones psicosociales en alcoholismo. Trastor Adict [Internet] 2003 [citado 2022 nov 12];5(1):22–6. Available from: https://www.elsevier.es/es-revista-trastornos-adictivos-182-articulo-intervenciones-psicosociales-alcoholismo-13045023
Ando Y, Jou JH. Nonalcoholic Fatty Liver Disease and Recent Guideline Updates. Clin Liver Dis [Internet] 2021;17(1):23–8. Available from: http://dx.doi.org/10.1002/cld.1045
Alcohol facts and statistics [Internet]. National Institute on Alcohol Abuse and Alcoholism. 2022;Available from: https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics
LaBrecque D., Abbas Z., Anania F., Ferenci P., Ghafoor Khan A., Goh K., Hamid S., Isakov V., Lizarzabal M., Mojica M., Rivera J., Sarin S., Štimac D., Thomson A., Umar M., Krabshuis J.,LeMair A. World Gastroenterology Organisation Global Guidelines: Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Gastroenterol latinoam [Internet] 2014 [citado 2022 nov 29];25(No 4):282–96. Available from: https://gastrolat.org/DOI/PDF/10.0716/gastrolat2014n400007b.pdf
Singh S, Singh PP, Roberts LR, Sanchez W. Chemopreventive strategies in hepatocellular carcinoma [Internet]. Nature Reviews Gastroenterology & Hepatology. 2014;11(1):45–54. Available from: http://dx.doi.org/10.1038/nrgastro.2013.143
World Health Organization (WHO). Cobertura vacunal [Internet]. Centro de prensa. 22 de abril de 2022;Available from: https://www.who.int/es/news-room/fact-sheets/detail/immunization-coverage
Combating hepatitis b and c to reach elimination by 2030 [Internet]. World Health Organization; 2016. Available from: https://apps.who.int/iris/bitstream/handle/10665/206453/WHO_HIV_2016.04_eng.pdf
World Health Organization (WHO). Hepatitis B [Internet]. Centro de prensa. 24 de junio de 2022;Available from: https://www.who.int/es/news-room/fact-sheets/detail/hepatitis-b
World Health Organization (WHO). Hepatitis C [Internet]. Centro de prensa. 24 de junio de 2022;Available from: https://www.who.int/es/news-room/fact-sheets/detail/hepatitis-c
Guidelines on hepatitis B and C testing [Internet]. World Health Organization; 2017. Available from: https://www.who.int/publications/i/item/9789241549981
Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection [Internet]. World Health Organization; 2015. Available from: https://apps.who.int/iris/bitstream/handle/10665/154590/9789241549059_eng.pdf?sequence=1&isAllowed=y
Carrat F, Fontaine H, Dorival C, et al. Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: a prospective cohort study. Lancet [Internet] 2019;393(10179):1453–64. Available from: http://dx.doi.org/10.1016/S0140-6736(18)32111-1
European Association for the Study of the Liver, Clinical Practice Guidelines Panel: Chair: EASL recommendations on treatment of hepatitis C: Final update of the series. J Hepatol [Internet] 2020;73(5):1170–218. Available from: http://dx.doi.org/10.1016/j.jhep.2020.08.018
Zhao C, Jin M, Le RH, et al. Poor adherence to hepatocellular carcinoma surveillance: A systematic review and meta-analysis of a complex issue. Liver Int [Internet] 2018;38(3):503–14. Available from: http://dx.doi.org/10.1111/liv.13555
Sachar Y, Brahmania M, Dhanasekaran R, Congly SE. Screening for Hepatocellular Carcinoma in Patients with Hepatitis B. Viruses [Internet] 2021 [citado 2022 nov 29];13(7):1318. Available from: https://www.mdpi.com/1999-4915/13/7/1318
Singal AG, El-Serag HB. Hepatocellular Carcinoma From Epidemiology to Prevention: Translating Knowledge into Practice. Clin Gastroenterol Hepatol [Internet] 2015;13(12):2140–51. Available from: http://dx.doi.org/10.1016/j.cgh.2015.08.014
Rodgers SK, Fetzer DT, Gabriel H, et al. Role of US LI-RADS in the LI-RADS Algorithm. Radiographics [Internet] 2019;39(3):690–708. Available from: http://dx.doi.org/10.1148/rg.2019180158
Nazal Ortiz L. Cirrosis Compensada: pronóstico, evaluación (VE/HCC), manejo: profilaxis de HDA, SHR, Infecciones. Farmacos, nutrición y ejercicio, cirugía [Internet]. Hospital FACH y Clínica Las Condes; 2015 [citado 2022 nov 29]. Available from: https://www.minsal.cl/wp-content/uploads/2015/10/Cirrosis-compensada.-Dra-Nazal.-02.10.2015.pdf
Gao Y, Yang T, Yin J, et al. Progress and prospects of biomarkers in primary liver cancer (Review). Int J Oncol [Internet] 2020 [citado 2022 oct 10];57(1):54–66. Available from: https://doi.org/10.3892/ijo.2020.5035
Gupta P, Soundararajan R, Patel A, Kumar-M P, Sharma V, Kalra N. Abbreviated MRI for hepatocellular carcinoma screening: A systematic review and meta-analysis. J Hepatol [Internet] 2021 [citado 2022 oct 10];75(1):108–19. Available from: http://www.journal-of-hepatology.eu/article/S016882782100091X/abstract
Wen N, Cai Y, Li F, et al. The clinical management of hepatocellular carcinoma worldwide: A concise review and comparison of current guidelines: 2022 update. Biosci Trends [Internet] 2022;16(1):20–30. Available from: http://dx.doi.org/10.5582/bst.2022.01061
Llovet JM, Kelley RK, Villanueva A, et al. Hepatocellular carcinoma. Nat Rev Dis Primers [Internet] 2021;7(1):6. Available from: http://dx.doi.org/10.1038/s41572-020-00240-3
Lee Y-T, Wang JJ, Zhu Y, Agopian VG, Tseng H-R, Yang JD. Diagnostic Criteria and LI-RADS for Hepatocellular Carcinoma. Clin Liver Dis [Internet] 2021;17(6):409–13. Available from: http://dx.doi.org/10.1002/cld.1075
Marrero JA, Kulik LM, Sirlin CB, et al. Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology [Internet] 2018;68(2):723–50. Available from: http://dx.doi.org/10.1002/hep.29913
Kim Y-Y, Lee S, Shin J, et al. Diagnostic Performance of Liver Imaging Reporting and Data System Version 2017 Versus Version 2018 for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Comparative Studies. J Magn Reson Imaging [Internet] 2021;54(6):1912–9. Available from: http://dx.doi.org/10.1002/jmri.27664
Chen X, Li M, Guo R, et al. The diagnostic performance of contrast-enhanced CT versus extracellular contrast agent-enhanced MRI in detecting hepatocellular carcinoma: direct comparison and a meta-analysis. Abdom Radiol (NY) [Internet] 2022;47(6):2057–70. Available from: http://dx.doi.org/10.1007/s00261-022-03484-7
Feng Z, Zhao H, Guan S, Wang W, Rong P. Diagnostic performance of MRI using extracellular contrast agents versus gadoxetic acid for hepatocellular carcinoma: A systematic review and meta-analysis. Liver Int [Internet] 2021;41(5):1117–28. Available from: http://dx.doi.org/10.1111/liv.14850
Peng J, Zhang T, Wang H, Ma X. The Value of Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System in the Diagnosis of Hepatocellular Carcinoma: A Meta-Analysis. J Ultrasound Med [Internet] 2022;41(6):1537–47. Available from: http://dx.doi.org/10.1002/jum.15837
Harding-Theobald E, Louissaint J, Maraj B, et al. Systematic review: radiomics for the diagnosis and prognosis of hepatocellular carcinoma. Aliment Pharmacol Ther [Internet] 2021;54(7):890–901. Available from: http://dx.doi.org/10.1111/apt.16563
Maki H, Hasegawa K. Advances in the surgical treatment of liver cancer. Biosci Trends [Internet]20 2022;16(3):178–88. Available from: http://dx.doi.org/10.5582/bst.2022.01245
Vilana R, Forner A, García Á, Ayuso C, Bru C. Carcinoma hepatocelular: diagnóstico, estadificación y estrategia terapéutica. Radiologia [Internet] 2010 [citado 2022 nov 29];52(5):385–98. Available from: https://www.elsevier.es/es-revista-radiologia-119-articulo-carcinoma-hepatocelular-diagnostico-estadif icacion-estrategia-S0033833810002195
Hendi M, Lv J, Cai X-J. Current status of laparoscopic hepatectomy for the treatment of hepatocellular carcinoma: A systematic literature review. Medicine [Internet] 2021;100(50):e27826. Available from: http://dx.doi.org/10.1097/MD.0000000000027826
Lerut J, Foguenne M, Lai Q. Hepatocellular cancer selection systems and liver transplantation: from the tower of babel to an ideal comprehensive score [Internet]. Updates in Surgery. 2021;73(5):1599–614. Available from: http://dx.doi.org/10.1007/s13304-021-01078-4
Silk T, Silk M, Wu J. Up to seven criteria in selection of systemic therapy for hepatocellular carcinoma.World J Gastroenterol [Internet] 2022;28(23):2561–8. Available from: http://dx.doi.org/10.3748/wjg.v28.i23.2561
Khajeh E, Moghadam AD, Eslami P, et al. Statin use is associated with the reduction in hepatocellular carcinoma recurrence after liver surgery. BMC Cancer [Internet] 2022;22(1):91. Available from: http://dx.doi.org/10.1186/s12885-022-09192-1
Hammad AY, Robbins JR, Turaga KK, Christians KK, Gamblin TC, Johnston FM. Palliative interventions for hepatocellular carcinoma patients: analysis of the National Cancer Database. Ann Palliat Med [Internet] 2017;6(1):26–35. Available from: http://dx.doi.org/10.21037/apm.2016.11.02
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