A Review of Inflammatory Bowel Disease in the Setting of Liver Transplantation

Gastroenterology & Hepatology October 2014, Volume 10, Issue 10 Veena Nannegari, MD, Saenz Roque, MD, David T. Rubin, MD, and Rodrigo Quera, MD Dr Nannegari […]

Hepatitis D Virus: A Call to Screening

Gastroenterology & Hepatology October 2014, Volume 10, Issue 10 Joseph Ahn, MD, MS, and Robert G. Gish, MD Dr Ahn is an associate professor of […]

Transition of Care in Inflammatory Bowel Disease

Gastroenterology & hepatology October 2014, Volume 10, Issue 10 Bincy P. Abraham, MD, MS, and Stacy A. Kahn, MD Dr Abraham is an assistant professor […]

Noninvasive Markers of Disease Activity in Inflammatory Bowel Disease

Gastroenterology & Hepatology September 2014, Volume 10, Issue 9 Raluca Vrabie, MD, and Sunanda Kane, MD Dr Vrabie is an assistant professor of clinical medicine […]

Current Diagnosis and Management of Suspected Reflux Symptoms Refractory to Proton Pump Inhibitor Therapy

Gastroenterology & Hepatology September 2014, Volume 10, Issue 9 Joel E. Richter, MD Dr Richter is a professor of medicine, the Hugh F. Culverhouse Chair […]

Management Strategies for Abdominal Bloating and Distension

Gastroenterology & Hepatology September 2014, Volume 10, Issue 9 Anna Foley, MBBS, FRACP, Rebecca Burgell, MBBS, FRACP, Jacqueline S. Barrett, MNutDiet, PhD, and Peter R. […]

Therapeutic Drug Monitoring of TNF Antagonists in Inflammatory Bowel Disease

Gastroenterology & Hepatology August 2014, Volume 10, Issue 8 Reena Khanna, MD, Barrett G. Levesque, MD, William J. Sandborn, MD, and Brian G. Feagan, MD Dr […]

Endoscopic Management of Gastrointestinal Fistulae

Gastroenterology & Hepatology August 2014, Volume 10, Issue 8 Nitin Kumar, MD, Michael C. Larsen, MD, and Christopher C. Thompson, MD, MSc, FACG, FASGE Dr Kumar […]

A Health Survey of Gastroenterologist Prescribing Practices of Adalimumab for Treatment of Crohn’s Disease: Final Results

troenterology & Hepatology August 2014, Volume 10, Issue 8 Samantha Zullow, MD, Mark H. Flasar, MD, MS,Deborah Greenberg, J. Kathleen Tracy, PhD, Ankur Rustgi, MBBS, MPH, and […]

Effects of Statins on the Risk of Hepatocellular Carcinoma

July 2014, Volume 10, Issue 7 Pejman G. Mansourian, MD, Masato Yoneda, MD, PhD, M. Krishna Rao, Fernando J. Martinez, MD, Emmanuel Thomas, MD, PhD, and […]

Eosinophilic Esophagitis and Proton Pump Inhibitors: Controversies and Implications for Clinical Practice

July 2014, Volume 10, Issue 7 W. Asher Wolf, MD, MPH, and Evan S. Dellon, MD, MPH Dr Wolf is a fellow in gastroenterology and hepatology […]

Obesity and Irritable Bowel Syndrome: A Comprehensive Review

July 2014, Volume 10, Issue 7 Octavia Pickett-Blakely, MD, MHS Dr Pickett-Blakely is the director of the Small Bowel Disorders and Nutrition Program in the Division […]

Immunizations in Children with Inflammatory Bowel Disease Treated with Immunosuppressive Therapy

Gastroenterology & Hepatology June 2014, Volume 10, Issue 6 Ying Lu, MD, and Athos Bousvaros, MD, MPH Dr Lu is an assistant professor in the Division of […]

Gastric Intestinal Metaplasia and Early Gastric Cancer in the West: A Changing Paradigm

Gastroenterology & Hepatology June 2014, Volume 10, Issue 6 Justin M. Gomez, MD, and Andrew Y. Wang, MD, FACG, FASGE Dr Gomez is a clinical instructor in […]

Hepatitis C Virus Infection and Its Rheumatologic Implications

Gastroenterology & Hepatology Volume 10, Issue 5 May 2014 287 Zeynel A. Sayiner, MD, Uzma Haque, MD, Mohammad U. Malik, MD, and Ahmet Gurakar, MD The […]

Common Anorectal Disorders

Gastroenterology & Hepatology May 2014, Volume 10, Issue 5 Amy E. Foxx-Orenstein, DO, Sarah B. Umar, MD, and Michael D. Crowell, PhD Dr Foxx-Orenstein is an associate […]

Controversies in the Diagnosis and Management of NAFLD and NASH

Gastroenterology & Hepatology April 2014, Volume 10, Issue 4 Mary E. Rinella, MD, Rohit Loomba, MD, MHSc, Stephen H. Caldwell, MD, Kris Kowdley, MD, Michael Charlton, MBBS, […]

Intestinal Microbiota and the Efficacy of Fecal Microbiota Transplantation in Gastrointestinal Disease

Gastroenterology & Hepatology April 2014, Volume 10, Issue 4 Olga C. Aroniadis, MD, and Lawrence J. Brandt, MD, AGA-F Dr Aroniadis is a gastroenterology fellow at Montefiore […]

Identifying Patients Most Likely to Have a Common Bile Duct Stone After a Positive Intraoperative Cholangiogram

Gastroenterology & Hepatology April 2014, Volume 10, Issue 4 Raja Vadlamudi, MD, MPH, Jason Conway, MD, MPH, Girish Mishra, MD, MS, John Baillie, MB ChB, FRCP, John […]

Current Management of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Despite efforts for prevention and screening as well as development of new technologies for diagnosis and treatment, the incidence of HCC has doubled, and mortality rates have increased in recent decades. A variety of important risk factors are associated with the development of HCC, with any type of cirrhosis, regardless of etiology, being the major contributor. Hepatitis C virus infection with bridging fibrosis or cirrhosis and hepatitis B virus infection are independent risk factors. The diagnosis of HCC is made without liver biopsy in over 90% of cases. Screening with ultrasound and alpha-fetoprotein (AFP) at 6-month intervals is advised; however, it is not adequate for patients on the orthotopic liver transplantation (OLT) list. Triple-phase computed tomography and/or magnetic resonance imaging are used in combination with the detection of AFP, AFP-L3%, and/or des-gamma-carboxy prothrombin due to their superior sensitivities and specificities. Several treatment modalities are available, but only surgical resection and OLT are curative. OLT is available only for patients who meet or are downstaged into Milan or University of California, San Francisco criteria. Other treatment options include radiofrequency ablation, microwave ablation, percutaneous ethanol injection, transarterial chemoembolization, radioembolization, cryoablation, radiation therapy, stereotactic radiotherapy, systemic chemotherapy, and molecularly targeted therapies. The management of HCC is based on tumor size and location, extrahepatic spread, and underlying liver function. Given the complexity of the disease, patients are often best served in centers with experience in HCC management, where a multidisciplinary approach can take place.